Provider Demographics
NPI:1073161857
Name:SAUNDERS, LATOYA RENE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:RENE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E PHIL ELLENA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1943
Mailing Address - Country:US
Mailing Address - Phone:215-715-0683
Mailing Address - Fax:
Practice Address - Street 1:428 E PHIL ELLENA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1943
Practice Address - Country:US
Practice Address - Phone:215-715-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN299038164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty