Individual
LATONYA WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, MHA, MS
Contact information
Practice address
17650 134TH AVE SE, S201, RENTON, WA 98058-6889
(612) 701-4301
Mailing address
635 MARYLAND AVE W, APT 208, SAINT PAUL, MN 55117-4160
(612) 701-4301
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1585841
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
642452000
—
MN
Enumeration date
09/29/2006
Last updated
12/21/2018
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