Healthcare Provider Details

I. General information

NPI: 1891278743
Provider Name (Legal Business Name): LATONIA QUEEN HOWARD FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W HEFNER RD
OKLAHOMA CITY OK
73114-6631
US

IV. Provider business mailing address

605 WASHINGTON ST
PORTSMOUTH OH
45662-3919
US

V. Phone/Fax

Practice location:
  • Phone: 405-896-8058
  • Fax:
Mailing address:
  • Phone: 740-353-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number77980
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number207674
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN225316
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017020484
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.408617
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: