Healthcare Provider Details

I. General information

NPI: 1902700578
Provider Name (Legal Business Name): LATRELLE HAMILTON BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TIBET AVE
SAVANNAH GA
31406-5540
US

IV. Provider business mailing address

111 TIBET AVE
SAVANNAH GA
31406-5540
US

V. Phone/Fax

Practice location:
  • Phone: 912-380-2427
  • Fax:
Mailing address:
  • Phone: 912-380-2427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: