Provider Demographics
NPI:1699976092
Name:HOWARD, LATUNYA HOLLIS
Entity type:Individual
Prefix:
First Name:LATUNYA
Middle Name:HOLLIS
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4768 WOODVILLE HWY APT 1733
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-0908
Mailing Address - Country:US
Mailing Address - Phone:850-980-2780
Mailing Address - Fax:
Practice Address - Street 1:4768 WOODVILLE HWY
Practice Address - Street 2:APT 1733
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-0908
Practice Address - Country:US
Practice Address - Phone:850-980-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL131188376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide