Individual
LATISHA NEWPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4085 SHAKERTOWN RD, BEAVERCREEK, OH 45430-1034
(937) 458-2509
(937) 429-7685
Mailing address
4085 SHAKERTOWN RD, BEAVERCREEK, OH 45430-1034
(937) 458-2509
(937) 429-7685
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
309681
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309681
REGISTERED NURSING LICENSE
OH
Enumeration date
10/13/2016
Last updated
10/13/2016
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