MEDICARE: LATOYA MARIE HERRING MEDICAL NAILTECH MNT

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	405300000X	Prevention Professional	51405461	AZ
2	246Z00000X	Other Specialist/Technologist	51405461	AZ

General Provider Information

NPI Number	:	1255281754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA MARIE HERRING MEDICAL NAILTECH MNT

Provider Business Mailing Address
First Line	:	999 E FRY BLVD STE 214
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-2619
Country	:	US
Telephone Number	:	520-210-1138
Fax Number	:

Provider Business Practice Location Address
First Line	:	999 E FRY BLVD STE 214
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-2619
Country	:	US
Telephone Number	:	520-210-1138
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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