Individual
MRS. LATASHA LASSETER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, FNP-C
Contact information
Practice address
400 TECHNOLOGY CT SE STE J, SMYRNA, GA 30082-5237
(770) 431-2354
Mailing address
3726 LAKE ENCLAVE WAY, ATLANTA, GA 30349-1890
(404) 273-9683
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN198732
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN198732
GA
Other
Enumeration date
03/14/2017
Last updated
07/27/2023
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