Healthcare Provider Details

I. General information

NPI: 1922936970
Provider Name (Legal Business Name): LAURIE'L JE'MERA LATIMER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3269 N STOCKTON HILL RD
KINGMAN AZ
86409-3619
US

IV. Provider business mailing address

950 EAGLES LANDING PKWY UNIT 623
STOCKBRIDGE GA
30281-7343
US

V. Phone/Fax

Practice location:
  • Phone: 928-681-8701
  • Fax:
Mailing address:
  • Phone: 678-541-8052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: