Individual
MRS. CARLY ALEXANDRA LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
24 ALBRO RD, MARATHON, NY 13803-2808
(607) 753-3797
Mailing address
85 SOUTH WEST STREET, HOMER, NY 13077
(607) 753-3797
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
340806
NY
Other
Enumeration date
08/03/2016
Last updated
03/22/2021
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