Provider Demographics
NPI:1184204570
Name:COLLINS, LATISHA LOVE (RMA, CNA, CAREGIVER)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:LOVE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RMA, CNA, CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 SHORT MAY ST
Mailing Address - Street 2:
Mailing Address - City:ELSMERE
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2166
Mailing Address - Country:US
Mailing Address - Phone:859-982-1231
Mailing Address - Fax:
Practice Address - Street 1:239 SHORT MAY ST
Practice Address - Street 2:
Practice Address - City:ELSMERE
Practice Address - State:KY
Practice Address - Zip Code:41018-2166
Practice Address - Country:US
Practice Address - Phone:859-982-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health