Individual
LATISHA WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2859 ANJAR AVE SW, PALM BAY, FL 32908-5027
(321) 704-9510
Mailing address
2859 ANJAR AVE SW, PALM BAY, FL 32908-5027
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5187064
FL
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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