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Organization

VENICE BEACH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN LATCHAM (OWNER)
(515) 884-7849
Entity
Organization

Contact information

Practice address
5465 MILLS CIVIC PKWY STE 243, WEST DES MOINES, IA 50266-5320
(515) 884-7849
Mailing address
5465 MILLS CIVIC PKWY STE 243, WEST DES MOINES, IA 50266-5320

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
06/06/2023
Last updated
12/16/2025
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