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General NPI Number Information
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NPI Number | 1225100167
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Entity Type | Individual
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Provider Name | JANET KATHERINE LATHAM R.N.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 1001 COLLEGE AVE STE B
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City | FORT WORTH
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State | TX
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Zip | 76104-3013
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Country | US
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Telephone | 817-336-6012
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Fax | 817-336-6013
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Provider Business Mailing Address
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Address Line | P.O. BOX 961205
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City | FORT WORTH
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State | TX
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Zip | 76161-1205
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Country | US
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Telephone | 817-740-8400
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Fax | 817-336-6013
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 226613
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License Number State | TX
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