Healthcare Provider Details

I. General information

NPI: 1679417398
Provider Name (Legal Business Name): MARQUISA LATTIMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8162 COLERAIN AVE
CINCINNATI OH
45239-4516
US

IV. Provider business mailing address

6162 DELCREST DR
FAIRFIELD OH
45014-5346
US

V. Phone/Fax

Practice location:
  • Phone: 513-546-8572
  • Fax:
Mailing address:
  • Phone: 513-546-8572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: