Individual
LATISHA S. ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
218 HESTER WOODS DR, COLUMBIA, SC 29223-8504
(803) 743-6655
Mailing address
1624 MAIN ST, COLUMBIA, SC 29201-2818
(803) 726-2350
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20950
SC
363LP2300X
Primary Care Nurse Practitioner
20950
SC
364SA2200X
Adult Health Clinical Nurse Specialist
20950
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4772
—
SC
Enumeration date
04/27/2017
Last updated
05/01/2018
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