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NPI Code Detail

MEDICARE: LATEESHA GATTIS

MEDICARE: LATEESHA GATTIS
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
1183500000XPharmacist0202207899VA

General Provider Information

NPI Number : 1811282015
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATEESHA GATTIS
Provider Business Mailing Address
First Line : 1800 CARL D SILVER PKWY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4960
Country : US
Telephone Number : 703-586-6133
Fax Number : 703-586-6846
Provider Business Practice Location Address
First Line : 1800 CARL D SILVER PKWY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4960
Country : US
Telephone Number : 540-786-2197
Fax Number : 540-786-2350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 11/22/2024

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