Individual
LATASHA EILEEN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2615 PARK CENTRAL BLVD, DECATUR, GA 30035-3907
(404) 667-0171
Mailing address
2615 PARK CENTRAL BLVD, DECATUR, GA 30035-3907
(404) 667-0171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN155558
GA
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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