Provider Demographics
NPI:1356616296
Name:COLLINS, LATOYA MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 N 49TH ST APT 203
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6433
Mailing Address - Country:US
Mailing Address - Phone:414-350-1799
Mailing Address - Fax:
Practice Address - Street 1:9419 N 49TH ST APT 203
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-6433
Practice Address - Country:US
Practice Address - Phone:414-350-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI312314-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse