Provider Demographics
NPI:1336913490
Name:LATHAN, CHRISTINE ALBERTA
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALBERTA
Last Name:LATHAN
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 1:9310 MEADOWGLEN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3603
Mailing Address - Country:US
Mailing Address - Phone:513-807-2905
Mailing Address - Fax:
Practice Address - Street 1:9310 MEADOWGLEN DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3603
Practice Address - Country:US
Practice Address - Phone:513-807-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN176234376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker