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Individual

LATASHA R COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4443 N 46TH STREET, MILWAUKEE, WI 53218
(414) 449-5240
Mailing address
4443 N 46TH ST, MILWAUKEE, WI 53218-5251
(414) 449-5240

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308903-031
WI

Other

Enumeration date
09/03/2008
Last updated
09/03/2008
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