Provider Demographics
NPI:1578120358
Name:PRICE, LATOYA LOREN (FNP)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:LOREN
Last Name:PRICE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 COLINDALE RD APT 208
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2480
Mailing Address - Country:US
Mailing Address - Phone:757-912-9083
Mailing Address - Fax:
Practice Address - Street 1:4301 COLINDALE RD APT 208
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-2480
Practice Address - Country:US
Practice Address - Phone:757-912-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1578120358Medicaid
VANAOtherI DO NOT HAVE A ISSUER AT THIS TIME