Provider Demographics
NPI:1609532431
Name:WHITTINGTON, LATOYA KATHIE
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:KATHIE
Last Name:WHITTINGTON
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 1:170 IVYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8349
Mailing Address - Country:US
Mailing Address - Phone:910-779-8075
Mailing Address - Fax:
Practice Address - Street 1:170 IVYWOOD LN
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8349
Practice Address - Country:US
Practice Address - Phone:910-779-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health