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NPI Code Detail

MEDICARE: AMY LATHEM NP

MEDICARE: AMY LATHEM NP
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
1363LA2100XAcute Care Nurse PractitionerAPRN-NP286263GA

General Provider Information

NPI Number : 1881450039
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LATHEM NP
Provider Business Mailing Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3899
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3899
Country : US
Telephone Number : 770-219-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2024
Last Update Date : 03/18/2026

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