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Individual

MRS. LATANE DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
597 BRIGHAM TRL, AUGUSTA, GA 30909-6060
(706) 288-9256
Mailing address
597 BRIGHAM TRL, AUGUSTA, GA 30909-6060
(706) 288-9256

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
21130
GA

Other

Enumeration date
01/29/2019
Last updated
01/29/2019
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