MEDICARE: TINA LASHAE PLEASANT

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
1	376K00000X	Nurse's Aide		LA

General Provider Information

NPI Number	:	1053245142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA LASHAE PLEASANT

Provider Business Mailing Address
First Line	:	112 COTTON BAYOU LN
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-7239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 COTTON BAYOU LN
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-7239
Country	:	US
Telephone Number	:	318-600-9687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ TINA LASHAE PLEASANT ” Practice Location

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