Provider Demographics
NPI:1780454686
Name:MASON, LATOYA NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:NICOLE
Last Name:MASON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38105 POST OFFICE RD STE 8
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4296
Mailing Address - Country:US
Mailing Address - Phone:225-402-2436
Mailing Address - Fax:225-255-2820
Practice Address - Street 1:38105 POST OFFICE RD STE 8
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-4296
Practice Address - Country:US
Practice Address - Phone:225-402-2436
Practice Address - Fax:225-255-2820
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA231516363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health