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Individual

MS. VANESSA LATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
675 MAIN STREET, MIDDLETOWN, CT 06457
(860) 347-6971
Mailing address
99 GROVE AVE, WILMINGTON, MA 01887-3720
(617) 922-4442

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
153972
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8926
CT

Other

Enumeration date
06/26/2020
Last updated
07/24/2020
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