Healthcare Provider Details

I. General information

NPI: 1467781757
Provider Name (Legal Business Name): LATASHA L JOHNIGAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8430 POINTE COUPEE RD
NEW ROADS LA
70760-4317
US

IV. Provider business mailing address

6450 LA HIGHWAY 1 STE B
BATCHELOR LA
70715-3212
US

V. Phone/Fax

Practice location:
  • Phone: 225-638-3767
  • Fax: 225-638-4058
Mailing address:
  • Phone: 225-618-5015
  • Fax: 225-442-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP05967
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberAP05967
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: