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LATASHA DEREE HINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-2100
Mailing address
2036 CHARTERHOUSE LN, WINTERVILLE, NC 28590-8017
(252) 560-2435

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
5018669
NC
363LA2100X
Acute Care Nurse Practitioner
HINE-3CL25
NC

Other

Enumeration date
08/22/2023
Last updated
11/27/2023
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