Provider Demographics
NPI:1225449077
Name:ROMNEY, LATISHA MONIQUE (FNP)
Entity type:Individual
Prefix:
First Name:LATISHA
Middle Name:MONIQUE
Last Name:ROMNEY
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 IRVING AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-5938
Mailing Address - Country:US
Mailing Address - Phone:646-276-8360
Mailing Address - Fax:
Practice Address - Street 1:400 IRVING AVE STE 104
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-5938
Practice Address - Country:US
Practice Address - Phone:646-276-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY759793163W00000X
NY315608164W00000X
NYF348653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse