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General NPI Number Information
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NPI Number | 1932633674
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Entity Type | Individual
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Provider Name | LATASHA JANETT WILLIAMS-PRINCE MSN, ARPN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 1490 MILSTEAD RD NE # A
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City | CONYERS
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State | GA
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Zip | 30012-3823
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Country | US
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Telephone | 770-922-2217
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Fax |
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Provider Business Mailing Address
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Address Line | 3372 CHESTERFIELD CT
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City | SNELLVILLE
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State | GA
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Zip | 30039-4607
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Country | US
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Telephone | 317-376-9840
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN226033
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License Number State | GA
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