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General NPI Number Information
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NPI Number | 1124821442
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Entity Type | Individual
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Provider Name | DIANA LATHON LVN
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 10514 OBERRENDER RD
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City | NEEDVILLE
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State | TX
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Zip | 77461-5700
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Country | US
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Telephone | 801-984-0633
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Fax | 801-984-0633
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Provider Business Mailing Address
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Address Line | 5500 MING AVE STE 410
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City | BAKERSFIELD
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State | CA
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Zip | 93309-4631
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 177787
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License Number State | TX
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