MEDICARE: LATOYA WEATHERSBY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	337822	NY
2	363LF0000X	Family Nurse Practitioner	1146968	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033459912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA WEATHERSBY FNP

Provider Business Mailing Address
First Line	:	4500 WASHINGTON AVE STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5477
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 WASHINGTON AVE STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5477
Country	:	US
Telephone Number	:	713-730-7416
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	12/02/2024

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Directions to “ LATOYA WEATHERSBY FNP” Practice Location

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