Individual
LATASHI THORPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
114 CHURCH ST, IRWINTON, GA 31042-2557
(478) 595-1344
Mailing address
PO BOX 40, IRWINTON, GA 31042-0040
(478) 595-1344
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
059037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059037
LPN
—
Enumeration date
06/29/2017
Last updated
06/29/2017
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