Provider Demographics
NPI:1639837115
Name:OWENSBY, LATASHA SHAMAY (CNA/HHA/MA)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:SHAMAY
Last Name:OWENSBY
Suffix:
Gender:F
Credentials:CNA/HHA/MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-1572
Mailing Address - Country:US
Mailing Address - Phone:765-210-7523
Mailing Address - Fax:
Practice Address - Street 1:912 CORNELL RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-1572
Practice Address - Country:US
Practice Address - Phone:765-210-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based