Individual
MS. LATAVIA CHALLENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
861443 WORTHINGTON DR, YULEE, FL 32097-6453
(910) 299-2466
Mailing address
861443 WORTHINGTON DR, YULEE, FL 32097-6453
(910) 299-2466
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0014194636
GA
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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