Individual
LATIFAH QUANAH JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
200 MEDICAL PARK DR STE 550, CONCORD, NC 28025-0947
(704) 403-1036
Mailing address
3069 LIGHT RIDGE CT SW, CONCORD, NC 28027-8989
(704) 930-3145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5015942
NC
Other
Enumeration date
11/19/2021
Last updated
12/01/2025
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