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General NPI Number Information
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NPI Number | 1497778690
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Entity Type | Individual
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Provider Name | LATASHA NICOLE BAXTER CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2121 MEDICAL PARK DR SUITE 2
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City | SILVER SPRING
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State | MD
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Zip | 20902-4054
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Country | US
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Telephone | 301-681-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 11312 BIG HORN CT
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City | BELTSVILLE
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State | MD
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Zip | 20705-1428
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Country | US
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Telephone | 716-310-5495
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R171236
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License Number State | MD
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