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NPI Code Detail

MEDICARE: MRS. LAURA JEAN LATA ANP

MEDICARE: MRS. LAURA JEAN LATA ANP
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
1363L00000XNurse PractitionerNP-1047AID
2363L00000XNurse Practitioner12540TN

General Provider Information

NPI Number : 1649224783
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA JEAN LATA ANP
Provider Business Mailing Address
First Line : PO BOX 2861
Second Line :
City : CROSSVILLE
State : TN
Zip : 38557-2861
Country : US
Telephone Number : 931-879-5864
Fax Number : 931-879-3903
Provider Business Practice Location Address
First Line : 100 S DUNCAN ST
Second Line :
City : JAMESTOWN
State : TN
Zip : 38556-3009
Country : US
Telephone Number : 931-879-5864
Fax Number : 931-879-3903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 04/09/2026

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Directions to “ MRS. LAURA JEAN LATA ANP” Practice Location

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