Individual provider · NPI-1
Latoya Haynes, LPN
Licensed Practical Nurse · Mableton, GA
NPI number1124700653
StatusActive
Last updated in NPPESAug 3, 2023
Details
- NPI
- 1124700653
- Entity type
- Individual (NPI-1)
- Name
- Latoya Haynes
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 3, 2023
- Certification date
- Aug 3, 2023
- Last updated
- Aug 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LPN091006 | GA | Yes |
Other names
- Latoya Blount (Former Name)
Practice location
5701 Mableton Pkwy Sw Ste 310Mableton, GA 30126-3360
Phone 678-799-1203
Mailing address
5701 Mableton Pkwy Sw Ste 310Mableton, GA 30126-3360
Phone 678-799-1203
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