Provider Demographics
NPI:1932633674
Name:WILLIAMS-PRINCE, LATASHA JANETT (MSN, ARPN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LATASHA
Middle Name:JANETT
Last Name:WILLIAMS-PRINCE
Suffix:
Gender:F
Credentials:MSN, ARPN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3372 CHESTERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4607
Mailing Address - Country:US
Mailing Address - Phone:317-376-9840
Mailing Address - Fax:
Practice Address - Street 1:1490 MILSTEAD RD NE # A
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3823
Practice Address - Country:US
Practice Address - Phone:770-922-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN226033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily