Provider Demographics
NPI:1467195719
Name:MAJETTE, LATARSHA
Entity Type:Individual
Prefix:
First Name:LATARSHA
Middle Name:
Last Name:MAJETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5926 APPLETON CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4914
Mailing Address - Country:US
Mailing Address - Phone:757-585-3077
Mailing Address - Fax:
Practice Address - Street 1:5926 APPLETON CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4914
Practice Address - Country:US
Practice Address - Phone:757-585-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-222775374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide