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Individual
MS. TINA M LATTA
Active
Individual
MS. TINA M LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNS, FNP-C MSN, ,
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003623A
IN
363LF0000X
Family Nurse Practitioner
4704205664
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000725157
ANTHEM
IN
01
—
127356
SIHO
IN
05
—
201027540
—
IN
Enumeration date
09/27/2005
Last updated
03/13/2023
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