Spencer, Latasha

Spencer, Latasha is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Spencer, Latasha can be contacted via phone (601) 815-5579.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 815-5579
Fax: (601) 984-4151
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R876428 Mississippi

Profile Details

NPI number 1508238791
LBN Legal business name Spencer, Latasha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2015
Last updated Aug 31st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508238791 NPPES
Mississippi MEDICAID 01427849
Mississippi Other P01668934

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