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Individual

CHERELLE J LATIKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
105 N HAYDEN ST, BELZONI, MS 39038-3931
(662) 836-7234
Mailing address
PO BOX 402, BELZONI, MS 39038-0402
(662) 836-7234

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
76630
MS
251J00000X
Nursing Care Agency
374U00000X
Home Health Aide
76630
MS
376K00000X
Nurse's Aide
76630
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2564
MS
Enumeration date
01/21/2022
Last updated
09/27/2023
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