Individual
LATISHA SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
364 WONDER DR, SPRINGTOWN, TX 76082-6147
(303) 886-7682
Mailing address
364 WONDER DR, SPRINGTOWN, TX 76082-6147
(303) 886-7682
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1073799
TX
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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