Individual
EMELIA LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-4054
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136221
TX
390200000X
Student in an Organized Health Care Education/Training Program
818817
TX
Other
Enumeration date
11/10/2017
Last updated
07/20/2021
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