Healthcare Provider Details

I. General information

NPI: 1649159088
Provider Name (Legal Business Name): LATASIA BELIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 RIVERGATE DR NW
HUNTERSVILLE NC
28078-0154
US

IV. Provider business mailing address

10725 RIVERGATE DR NW
HUNTERSVILLE NC
28078-0154
US

V. Phone/Fax

Practice location:
  • Phone: 843-240-8366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: