Individual provider · NPI-1
Latisha Carol Colburn, RN
Registered Nurse, General Practice · Lewisburg, TN
NPI number1316872286
StatusActive
Last updated in NPPESJun 15, 2026
Details
- NPI
- 1316872286
- Entity type
- Individual (NPI-1)
- Name
- Latisha Carol Colburn
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 15, 2026
- Certification date
- Jun 14, 2026
- Last updated
- Jun 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | 0000267223 | TN | Yes |
| 364SH1100X | Clinical Nurse Specialist, Holistic | 0000267223 | TN |
Practice location
1639 Ramblewood DrLewisburg, TN 37091-4032
Phone 574-780-3560
Mailing address
1639 Ramblewood DrLewisburg, TN 37091-4032
Phone 574-780-3560
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