Individual
MS. VICKI LEGRAND LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3200 NORTHLINE AVE., STE 130, GREENSBORO, NC 27408-7600
(336) 286-6565
(336) 286-6566
Mailing address
3200 NORTHLINE AVE., STE 130, GREENSBORO, NC 27408-7600
(336) 286-6565
(336) 286-6566
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
165
NC
367A00000X
Advanced Practice Midwife
165
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7821
ACNM CERTIFICATE NUMBER
NC
Enumeration date
11/15/2006
Last updated
12/10/2012
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