| Latonya S Mims, CRNA | |
|
2427 Lakecrest Dr, Shreveport, LA 71109-3003 | |
| (318) 560-2312 | |
| Not Available |
| Full Name | Latonya S Mims |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 2427 Lakecrest Dr, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801879754 | NPI | - | NPPES |
| 110172339A | Medicaid | MA | |
| 1195901 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN243434 (Massachusetts) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 668574 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| John Randolph Medical Center | Hopewell, VA | Hospital |
| Cjw Medical Center | Richmond, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dogwood Anesthesia Providers Llc | 2769853084 | 158 |
| Entity Name | Dogwood Anesthesia Providers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982329900 PECOS PAC ID: 2769853084 Enrollment ID: O20230125000989 |
| Mailing Address | Practice Location Address |
|---|---|
| Latonya S Mims, CRNA 2427 Lakecrest Dr, Shreveport, LA 71109-3003 Ph: (318) 560-2312 | Latonya S Mims, CRNA 2427 Lakecrest Dr, Shreveport, LA 71109-3003 Ph: (318) 560-2312 |
Billy B Miller Iii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118 Phone: 318-212-5000 | |
Ms. Lisa Nicole Kellogg, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 | |
Kurvis Antione Davis, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 367 Carrollton Ave, Shreveport, LA 71105 Phone: 318-573-0604 | |
Brian House, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Benjamin R. Wisenbaker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 Fax: 318-629-4833 | |
Michael Liles, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 | |
Kerri Annette Mullone, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |