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Latore Williams

Licensed Practical Nurse in Stone Mountain, GA. Individual provider (NPI-1).

NPI number1265829824
StatusActive
Last updated in NPPESSep 11, 2020

Details

NPI
1265829824
Entity type
Individual (NPI-1)
Name
Latore Williams
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 22, 2015
Certification date
Sep 11, 2020
Last updated
Sep 11, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical NurseLPN82505GAYes

Practice location

5300 Ridge Forest Drive
Stone Mountain, GA 30083

Phone 404-399-7713

Mailing address

5825 Lakeview Cir
Lithonia, GA 30058-1843

Phone 140-439-9771

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