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Individual

LEA LATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1215 N BEAVER ST STE 203, FLAGSTAFF, AZ 86001-3120
(928) 773-2200
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP4386
AZ

Other

Enumeration date
10/11/2012
Last updated
07/02/2025
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