Individual
MRS. LAURA JEAN LATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6615 COMANCHE STREET, BONNERS FERRY, ID 83805
(931) 879-5864
(931) 879-3903
Mailing address
PO BOX 2861, CROSSVILLE, TN 38557-2861
(931) 879-5864
(931) 879-3903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
12540
TN
363L00000X
Nurse Practitioner
Primary
NP-1047A
ID
Other
Enumeration date
05/22/2006
Last updated
07/28/2026
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