Provider Demographics
NPI:1881496370
Name:WILEY, LATASHA NICOLE
Entity type:Individual
Prefix:MS
First Name:LATASHA
Middle Name:NICOLE
Last Name:WILEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 HUNNICUTT LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5832
Mailing Address - Country:US
Mailing Address - Phone:513-371-9447
Mailing Address - Fax:
Practice Address - Street 1:4155 HUNNICUTT LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5832
Practice Address - Country:US
Practice Address - Phone:513-371-9447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty