Individual
KATHLEEN LILAH LATCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R060182-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229725600
—
MN
01
—
430013664
RAILROAD MEDICARE
MN
05
—
44377900
—
WI
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
03/24/2006
Last updated
06/14/2010
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