Latham, Jessica Lynn

Latham, Jessica Lynn is an individual health care provider with primary practice located at 1133 Dunn Rd Suite 2335, St Louis MO 63136-6119. She recently has 3 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Latham, Jessica Lynn can be contacted via phone (314) 653-5007.

Contact Information

Primary practice address
1133 Dunn Rd Suite 2335 St Louis MO 63136-6119
Phone: (314) 653-5007
Fax: (314) 653-5007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 060472784 Illinois
Nursing Service Providers / Emergency 163WE0003X 2010040204 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2015028258 Missouri

Profile Details

NPI number 1073980611
LBN Legal business name Latham, Jessica Lynn
Credentials AGNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2015
Last updated Jul 21st, 2022 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1073980611 NPPES
Missouri MEDICAID 1073980611

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