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NPI Code Detail

MEDICARE: LATROYA MAHAN

MEDICARE: LATROYA MAHAN
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1982546958
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATROYA MAHAN
Provider Business Mailing Address
First Line : 1027 FREDERICK ST
Second Line :
City : BLUEFIELD
State : WV
Zip : 24701-3942
Country : US
Telephone Number : 304-327-5305
Fax Number :
Provider Business Practice Location Address
First Line : 1027 FREDERICK ST
Second Line :
City : BLUEFIELD
State : WV
Zip : 24701-3942
Country : US
Telephone Number : 304-327-5305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ LATROYA MAHAN ” Practice Location

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