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Latasha Crockett
Gerontology Nurse Practitioner in Addison, Texas
NPI 1417661588

Latasha Crockett is a Gerontology Nurse Practitioner based in Fort Worth, TX and is specialized in Gerontology. Latasha Crockett practices in Addison, TX. The NPI Number for Latasha Crockett is 1417661588 and holds a License No. 1091068 (Texas).

The current practice location address for Latasha Crockett is 15301 Spectrum Dr Ste 330, Addison, TX and can be reached out via phone at 972-661-2273.

Location: 15301 Spectrum Dr Ste 330, Addison, TX, 76123-1575
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417661588
Provider Name
Latasha Crockett
Credential
Provider Entity Type
Individual
Gender
Female
Address
15301 Spectrum Dr Ste 330, Addison, TX, 76123-1575
Phone Number
972-661-2273
Fax Number
Provider Enumeration Date
01/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
15301 Spectrum Dr Ste 330
City
Addison
State
Texas
Zip
75001-6462
Phone Number
972-661-2273
Fax Number
person
Provider Business Mailing Address Details
Address
15301 Spectrum Dr Ste 330
City
Addison
State
Texas
Zip
75001-6462
Phone Number
972-661-2273
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
1091068 (Texas)
Definition
Definition to come...
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