Healthcare Provider Details

I. General information

NPI: 1750295614
Provider Name (Legal Business Name): KIERA JEAN LATTA MSN, APRN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

4809 CLIFFONY DR
VIRGINIA BEACH VA
23464-8403
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7000
  • Fax:
Mailing address:
  • Phone: 321-505-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0024198393
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: