Individual
LATASHA MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3942 DUNGAN ST, PHILADELPHIA, PA 19124-5506
(610) 638-9693
Mailing address
3942 DUNGAN ST, PHILADELPHIA, PA 19124-5506
(610) 638-9693
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
RN706813
PA
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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