Provider Demographics
NPI:1013005297
Name:LATIMER, JULIE DENISE (LVN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:DENISE
Last Name:LATIMER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 ROSALIND STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838
Mailing Address - Country:US
Mailing Address - Phone:916-840-7074
Mailing Address - Fax:707-439-3103
Practice Address - Street 1:1532 ROSALIND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-4535
Practice Address - Country:US
Practice Address - Phone:916-840-7074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN285688164X00000X
OKL0037140164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse