Provider Demographics
NPI:1396623161
Name:MARTIN, LATIKA NYLA
Entity type:Individual
Prefix:
First Name:LATIKA
Middle Name:NYLA
Last Name:MARTIN
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 1:2350 PARK PLACE DR APT 49
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3074
Mailing Address - Country:US
Mailing Address - Phone:504-224-3191
Mailing Address - Fax:
Practice Address - Street 1:2439 MANHATTAN BLVD STE 308
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5396
Practice Address - Country:US
Practice Address - Phone:504-264-7189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty