Individual
LATASHA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 N 81ST ST, EAST SAINT LOUIS, IL 62203-1824
(618) 434-0461
Mailing address
625 N 81ST ST, EAST SAINT LOUIS, IL 62203-1824
(618) 434-0461
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043104151
IL
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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