Provider Information for 1679152789
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LATTISHA NAYLOR
Sex: Female
NPI: 1679152789
Last Updated: 2021-04-06
Certification Date: 2021-04-06
Certification Date: 2021-04-06
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679152789 | ||||||||
| Enumeration Date | 2021-04-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1303 TIDES EDGE CT HAMPTON, VA 23666-4185 United States Phone: 757-768-5824 | Fax: | ||||||||
| Primary Practice Address | 7225 HANOVER PKWY STE C GREENBELT, MD 20770-2024 United States Phone: 240-459-3074 | Fax: | ||||||||
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