Healthcare Provider Details

I. General information

NPI: 1720330160
Provider Name (Legal Business Name): PIERRETTE GENIA LATIMORE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FOREST GLEN RD STE 525
SILVER SPRING MD
20910-1466
US

IV. Provider business mailing address

8110 MAPLE LAWN BLVD STE 235
FULTON MD
20759-2694
US

V. Phone/Fax

Practice location:
  • Phone: 301-593-8101
  • Fax: 301-593-1537
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR183914
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: