Latasha Dubose

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN094202 Issued in GA

Practice address

2930 Bluff Winds PL
Douglasville, GA 30135-8683

Phone

(678) 695-3734

NPI assigned

Jul 29, 2017

Last updated

Jul 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501286400000",
    "number": "1013431220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8491 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342412",
            "telephone_number": "678-695-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 BLUFF WINDS PL",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358683",
            "telephone_number": "678-695-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "LATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-29",
        "last_updated": "2017-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN094202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Draper, RBT
• DRD Private Home Care
• Towanna Driver, RN
• Bettye Drye-Glover, MD
• DTS Reliable Transportation, LLC
• Latasha Dudley, BBA, M. ED.
• Deborah Tiana Dunn, MS BCBA
• Marie Maude Durandisse
• Samuel Grey Barnhouse Durrett, M.D.
• Dva Healthcare Renal Care Inc (Douglasville Dialysis)

• Licensed Practical Nurse in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.