Provider Demographics
NPI:1811590367
Name:HARBIN, LATEAK (FNP-C)
Entity type:Individual
Prefix:
First Name:LATEAK
Middle Name:
Last Name:HARBIN
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 STATE LINE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3212
Mailing Address - Country:US
Mailing Address - Phone:816-363-2600
Mailing Address - Fax:816-523-0068
Practice Address - Street 1:9001 STATE LINE RD STE 300
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3212
Practice Address - Country:US
Practice Address - Phone:816-363-2600
Practice Address - Fax:816-523-0068
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83856-011363LF0000X
MO2020038847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily