Healthcare Provider Details

I. General information

NPI: 1740145119
Provider Name (Legal Business Name): LATISHA MCGRAW MSN APN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 AAA DR STE 101
HAMILTON NJ
08691-1814
US

IV. Provider business mailing address

3 AAA DR STE 101
HAMILTON NJ
08691-1814
US

V. Phone/Fax

Practice location:
  • Phone: 609-406-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15491100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: