Bristol, Latisha Olivia

Bristol, Latisha Olivia is an individual health care provider with primary practice located at 60 Prosperity Ln , Stafford VA 22556-4605. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bristol, Latisha Olivia can be contacted via phone (540) 658-2811.

Contact Information

Primary practice address
60 Prosperity Ln Stafford VA 22556-4605
Phone: (540) 658-2811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110004651 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA030279 District of Columbia

Profile Details

NPI number 1265597538
LBN Legal business name Bristol, Latisha Olivia
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Feb 15th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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