Provider Demographics
NPI:1851004337
Name:KIEL, LATASHIA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LATASHIA
Middle Name:
Last Name:KIEL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18980 N MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4498
Mailing Address - Country:US
Mailing Address - Phone:512-652-8384
Mailing Address - Fax:
Practice Address - Street 1:18980 N MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4498
Practice Address - Country:US
Practice Address - Phone:512-652-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily