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General NPI Number Information
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NPI Number | 1497942007
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Entity Type | Individual
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Provider Name | LATOYA P. GIPSON WHNP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 8001 YOUREE DR SUITE 600
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City | SHREVEPORT
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State | LA
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Zip | 71115-2302
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Country | US
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Telephone | 318-212-3890
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Fax | 318-212-3888
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Provider Business Mailing Address
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Address Line | 8001 YOUREE DR SUITE 600
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City | SHREVEPORT
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State | LA
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Zip | 71115-2302
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Country | US
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Telephone | 318-212-3890
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Fax | 318-212-3888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN106410 AP05276
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License Number State | LA
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