Individual
LATRELLA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 FARRIS CT APT 105, RALEIGH, NC 27610-2466
(919) 825-7130
Mailing address
109 FARRIS CT APT 105, RALEIGH, NC 27610-2466
(919) 825-7130
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
67998
NC
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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