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General NPI Number Information
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NPI Number | 1922402247
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Entity Type | Individual
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Provider Name | LATISHA HOUZE-REED FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 1411 BRADLEY AVENUE
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City | BEAUMONT
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State | MS
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Zip | 39423-0235
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Country | US
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Telephone | 601-784-3922
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Fax | 601-784-3755
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Provider Business Mailing Address
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Address Line | PO BOX 1729
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City | HATTIESBURG
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State | MS
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Zip | 39403-1729
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Country | US
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Telephone | 601-545-8700
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Fax | 601-450-2493
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R864309
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License Number State | MS
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