Provider Demographics
NPI:1750746178
Name:WHITE, LATOYA JONES (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:JONES
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NORTHSIDE DR NW APT 1552
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5499
Mailing Address - Country:US
Mailing Address - Phone:708-595-5366
Mailing Address - Fax:
Practice Address - Street 1:9300 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4953
Practice Address - Country:US
Practice Address - Phone:708-595-5366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily