Basic Information
| Provider Information | |||||||||
| NPI: | 1427550763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASON | ||||||||
| FirstName: | TOSHA | ||||||||
| MiddleName: | DANIELLE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 INEICHEN ST STE A | ||||||||
| Address2: | |||||||||
| City: | RAYVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712693223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184177780 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 114 INEICHEN ST STE A | ||||||||
| Address2: | |||||||||
| City: | RAYVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712693223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184177780 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2018 | ||||||||
| LastUpdateDate: | 03/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 291080 | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.