Individual
MRS. GINA MICHELLE LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1700 W TOWNLINE ST, CRESTON, IA 50801-1054
(641) 782-7091
Mailing address
1700 W TOWNLINE ST, CRESTON, IA 50801-1054
(641) 782-3657
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A104467
IA
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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