Provider Demographics
NPI:1942818992
Name:HALL, LATRICE (LABORATORY TECH)
Entity Type:Individual
Prefix:MS
First Name:LATRICE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LABORATORY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7464 W SAHARA AVE # 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2740
Mailing Address - Country:US
Mailing Address - Phone:702-827-1525
Mailing Address - Fax:
Practice Address - Street 1:7464 W SAHARA AVE # 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2740
Practice Address - Country:US
Practice Address - Phone:702-827-1525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV246RP1900X, 246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory