Provider Demographics
NPI:1346875259
Name:BROWN, LATASHA S (CNM, WHNP-BC, APNP)
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM, WHNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7262 N CASSIE AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-3651
Mailing Address - Country:US
Mailing Address - Phone:267-979-9212
Mailing Address - Fax:
Practice Address - Street 1:7262 N CASSIE AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-3651
Practice Address - Country:US
Practice Address - Phone:267-979-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148998-32367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife