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Shantel Latta, FNP-C
Family Nurse Practitioner in Blackstone, Virginia
NPI 1962092932

Shantel Latta is a Family Nurse Practitioner based in Blackstone, VA and is specialized in Family. Shantel Latta practices in Blackstone, VA and has the professional credentials of FNP-C. The NPI Number for Shantel Latta is 1962092932 and holds a License No. 0024180790 (Virginia).

The current practice location address for Shantel Latta is 103 E Broad St, Blackstone, VA and can be reached out via phone at 434-264-3221.

Location: 103 E Broad St, Blackstone, VA, 23824-0635
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962092932
Provider Name
Shantel Latta
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
103 E Broad St, Blackstone, VA, 23824-0635
Phone Number
434-264-3221
Fax Number
Provider Enumeration Date
01/22/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
103 E Broad St
City
Blackstone
State
Virginia
Zip
23824-1815
Phone Number
434-264-3221
Fax Number
person
Provider Business Mailing Address Details
Address
103 E Broad St
City
Blackstone
State
Virginia
Zip
23824-1815
Phone Number
434-264-3221
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
0024180790 (Virginia)
Definition
Definition to come...
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