Individual
KERRY HANNIFIN LATKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
300 HEALTH PARK BLVD, SUITE 4000, ST AUGUSTINE, FL 32086-3707
(904) 824-8666
(904) 824-8933
Mailing address
300 HEALTH PARK BLVD, SUITE 4000, ST AUGUSTINE, FL 32086-3707
(904) 824-8666
(904) 824-8933
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP 9173044
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010393000
—
FL
Enumeration date
01/06/2014
Last updated
05/01/2014
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