Provider Demographics
NPI:1811875362
Name:WOODFORK, LATOSHA LYNETTE
Entity type:Individual
Prefix:
First Name:LATOSHA
Middle Name:LYNETTE
Last Name:WOODFORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 TOULON DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-5120
Mailing Address - Country:US
Mailing Address - Phone:225-819-7448
Mailing Address - Fax:
Practice Address - Street 1:2720 TOULON DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5120
Practice Address - Country:US
Practice Address - Phone:225-819-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN825746163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health