Healthcare Provider Details

I. General information

NPI: 1609558006
Provider Name (Legal Business Name): LATASHA JO MCVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 STATE ST
DICKSON TN
37055-2082
US

IV. Provider business mailing address

227 COUNTY ROAD 547
CORINTH MS
38834-7967
US

V. Phone/Fax

Practice location:
  • Phone: 615-879-3582
  • Fax:
Mailing address:
  • Phone: 662-416-2862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number906141
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number35270
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: