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General NPI Number Information
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NPI Number | 1982300638
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Entity Type | Individual
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Provider Name | LATECIA ELSTON RHODEN AGACRNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 803 NORTH ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2529
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Country | US
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Telephone | 256-362-3636
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Fax | 256-649-3361
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Provider Business Mailing Address
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Address Line | 204 SUNLIGHT CIR
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City | TALLADEGA
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State | AL
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Zip | 35160-2690
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Country | US
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Telephone | 256-375-5479
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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 | 1-146018
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-146018
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License Number State | AL
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