Individual
ELIZABETH G. LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.-C
Contact information
Practice address
467 VISTA AVE., PAGE, AZ 86040-1625
(928) 645-8123
(928) 645-3862
Mailing address
PO BOX 1625, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-2626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN067045/AP0855
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645252
—
AZ
Enumeration date
03/08/2006
Last updated
06/15/2011
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