Provider Demographics
NPI:1154698231
Name:STEVENSON-EVANS, LATAWNYA (RN)
Entity type:Individual
Prefix:MRS
First Name:LATAWNYA
Middle Name:
Last Name:STEVENSON-EVANS
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 1:40318 BORDEAUX ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-5432
Mailing Address - Country:US
Mailing Address - Phone:225-362-7212
Mailing Address - Fax:866-465-7549
Practice Address - Street 1:40318 BORDEAUX ST
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-5432
Practice Address - Country:US
Practice Address - Phone:225-362-7212
Practice Address - Fax:866-465-7549
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2271607163W00000X
LA128813163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse