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NPI Code Detail

MEDICARE: KASEY LATTIER NP

MEDICARE: KASEY LATTIER NP
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
1363L00000XNurse PractitionerAP08922LA
2363LF0000XFamily Nurse PractitionerAP08922LA

General Provider Information

NPI Number : 1457704306
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY LATTIER NP
Provider Business Mailing Address
First Line : 1860 FAIRFIELD AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4431
Country : US
Telephone Number : 318-675-1313
Fax Number : 318-675-1319
Provider Business Practice Location Address
First Line : 1860 FAIRFIELD AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4431
Country : US
Telephone Number : 318-675-1313
Fax Number : 318-675-1319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2016
Last Update Date : 06/04/2026

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