Healthcare Provider Details

I. General information

NPI: 1114670932
Provider Name (Legal Business Name): LATONYA SANDERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4443 READING RD # 203
CINCINNATI OH
45229-1252
US

IV. Provider business mailing address

4443 READING RD # 203
CINCINNATI OH
45229-1252
US

V. Phone/Fax

Practice location:
  • Phone: 513-899-8894
  • Fax:
Mailing address:
  • Phone: 513-899-8894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN457823
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number36D2248553
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: