MEDICARE: LATASHA TRIPLETT

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	376K00000X	Nurse's Aide	WI036846501996	WI

General Provider Information

NPI Number	:	1205635844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATASHA TRIPLETT

Provider Business Mailing Address
First Line	:	2565 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-2516
Country	:	US
Telephone Number	:	414-418-8901
Fax Number	:

Provider Business Practice Location Address
First Line	:	2565 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-2516
Country	:	US
Telephone Number	:	414-418-8901
Fax Number	:

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

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/07/2025

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Directions to “ LATASHA TRIPLETT ” Practice Location

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