Individual
MR. MICAH LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1208 BROWNWOOD ST, MALVERN, AR 72104-2202
(540) 446-9297
Mailing address
1208 BROWNWOOD ST, MALVERN, AR 72104-2202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
213314
AR
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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