Provider Demographics
NPI:1043738909
Name:BUFORD, LATOYA KATRESE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:KATRESE
Last Name:BUFORD
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MRS
Other - First Name:LATOYA
Other - Middle Name:KATRESE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:305 CARROLLTON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:GA
Mailing Address - Zip Code:30179-3796
Mailing Address - Country:US
Mailing Address - Phone:678-830-2294
Mailing Address - Fax:678-890-5840
Practice Address - Street 1:305 CARROLLTON ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:GA
Practice Address - Zip Code:30179-3796
Practice Address - Country:US
Practice Address - Phone:678-830-2294
Practice Address - Fax:678-890-5840
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206267163WM0705X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical