Individual
LATASHA R BURROUGHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
300 CARTER DRIVE, GROVE HILL, AL 36451
(251) 275-4135
Mailing address
PO BOX 964, MONROEVILLE, AL 36461-0964
(251) 575-4203
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-123087
AL
Other
Enumeration date
10/11/2011
Last updated
10/13/2011
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