Provider Demographics
NPI:1568729804
Name:ADAMS, LATOYA DANIELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:DANIELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2459 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4031
Mailing Address - Country:US
Mailing Address - Phone:602-576-7231
Mailing Address - Fax:
Practice Address - Street 1:2459 W PARK AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4031
Practice Address - Country:US
Practice Address - Phone:602-576-7231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP047722164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse