Provider Demographics
NPI:1477860450
Name:PINKSTON, LATOYA N (NP)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:N
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EAGLE SPRING DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6328
Mailing Address - Country:US
Mailing Address - Phone:770-213-3366
Mailing Address - Fax:404-962-6943
Practice Address - Street 1:125 EAGLE SPRING DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6328
Practice Address - Country:US
Practice Address - Phone:770-213-3366
Practice Address - Fax:404-962-6943
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN140882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily