Provider Demographics
NPI:1891579074
Name:LEVERETTE, LATOYIA SHONTE (RN)
Entity Type:Individual
Prefix:
First Name:LATOYIA
Middle Name:SHONTE
Last Name:LEVERETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 SOUTHWESTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2660
Mailing Address - Country:US
Mailing Address - Phone:502-599-5477
Mailing Address - Fax:
Practice Address - Street 1:1005 SOUTHWESTERN PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-2660
Practice Address - Country:US
Practice Address - Phone:502-599-5477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1119825163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse