Individual
MRS. JORDANA LEANNE LATOZAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CCRN, ACNP
Contact information
Practice address
1330 GRAND BLANC, GRAND BLANC, MI 48439-5801
(734) 464-0887
(734) 402-0254
Mailing address
36115 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704253776
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704253776
MI
363LA2200X
Adult Health Nurse Practitioner
4704253776
MI
Other
Enumeration date
12/08/2010
Last updated
05/27/2020
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