Provider Demographics
NPI:1376981191
Name:YARBROUGH, LATRINA SHAVON (ACNP-C)
Entity Type:Individual
Prefix:
First Name:LATRINA
Middle Name:SHAVON
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:ACNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 PHILLIPS ALY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-4525
Mailing Address - Country:US
Mailing Address - Phone:803-730-2532
Mailing Address - Fax:
Practice Address - Street 1:2010 PHILLIPS ALY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-4525
Practice Address - Country:US
Practice Address - Phone:803-730-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990761-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care