Individual
LATASHA MARIE WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4 E B ST, WELLSTON, OH 45692-1214
(740) 418-0804
Mailing address
4 E B ST, WELLSTON, OH 45692-1214
(740) 418-0804
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN.180214.MEDS.IV
OH
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181588
—
OH
Enumeration date
08/04/2022
Last updated
08/04/2022
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