Provider Demographics
NPI:1619110509
Name:WHITTLE, JA'MONDA LATRESS (RN)
Entity Type:Individual
Prefix:MRS
First Name:JA'MONDA
Middle Name:LATRESS
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6738 CORDIA CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9044
Mailing Address - Country:US
Mailing Address - Phone:513-777-6738
Mailing Address - Fax:513-777-0071
Practice Address - Street 1:6738 CORDIA CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9044
Practice Address - Country:US
Practice Address - Phone:513-777-6738
Practice Address - Fax:513-777-0071
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH344083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse