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General NPI Number Information
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NPI Number | 1053764670
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Entity Type | Organization
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Legal Business Name | NORINE LATIZKE ARNP, LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 1018 THOMASVILLE RD STE 106
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6271
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Country | US
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Telephone | 850-878-0484
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Fax |
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Provider Business Mailing Address
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Address Line | 1529 CHOWKEEBIN NENE
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City | TALLAHASSEE
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State | FL
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Zip | 32301-4705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NORINE BARDILL LABITZKE
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Credential | ARNP
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Telephone | 850-878-0484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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