Provider Demographics
NPI:1740971845
Name:LATTIMORE-KING, LATONYA
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:
Last Name:LATTIMORE-KING
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 1:1702 TODDS LN STE 140
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3195
Mailing Address - Country:US
Mailing Address - Phone:757-344-8296
Mailing Address - Fax:
Practice Address - Street 1:1702 TODDS LN STE 140
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3195
Practice Address - Country:US
Practice Address - Phone:757-344-8296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-253218374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide