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NPI Code Detail

MEDICARE: JASHUNTA LATIA CARSON APRN, PMHNP-BC, CRNP

MEDICARE: JASHUNTA LATIA CARSON APRN, PMHNP-BC, CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11012291FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP130833TX

General Provider Information

NPI Number : 1760836399
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASHUNTA LATIA CARSON APRN, PMHNP-BC, CRNP
Provider Business Mailing Address
First Line : 8300 N LAMAR BLVD STE 200A
Second Line :
City : AUSTIN
State : TX
Zip : 78753-5976
Country : US
Telephone Number : 888-201-5112
Fax Number : 512-782-9316
Provider Business Practice Location Address
First Line : 7877 WILLOW CHASE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77070-5934
Country : US
Telephone Number : 832-869-4818
Fax Number : 832-241-2902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2016
Last Update Date : 12/31/2025

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