Provider Demographics
NPI:1275148082
Name:VASSEL, LATANGELA SHONTA (CNA)
Entity Type:Individual
Prefix:
First Name:LATANGELA
Middle Name:SHONTA
Last Name:VASSEL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:LATANGELA
Other - Middle Name:SHONTA
Other - Last Name:VASSEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:1104 BARTOW RD APT N163
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5826
Mailing Address - Country:US
Mailing Address - Phone:186-339-9731
Mailing Address - Fax:
Practice Address - Street 1:1104 BARTOW RD APT N163
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5826
Practice Address - Country:US
Practice Address - Phone:186-339-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion