MEDICARE: LATIKA MARIE WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	SU773726	OH

General Provider Information

NPI Number	:	1245196567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATIKA MARIE WHITE

Provider Business Mailing Address
First Line	:	1425 TAMPA AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3849
Country	:	US
Telephone Number	:	937-238-1542
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 TAMPA AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3849
Country	:	US
Telephone Number	:	937-238-1542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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Directions to “ LATIKA MARIE WHITE ” Practice Location

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