Individual
MRS. MELISSA DANIELLE LATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
407 E JEFFERSON ST, BOURBON, IN 46504-1451
(574) 217-3520
Mailing address
407 E JEFFERSON ST, BOURBON, IN 46504-1451
(574) 217-3520
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA0806682
IN
Other
Enumeration date
11/16/2022
Last updated
02/12/2023
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