Latham, Mia

Latham, Mia is an individual health care provider with primary practice located at 3601 4Th St Suite 3B100, Lubbock TX 79430-0002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Latham, Mia can be contacted via phone (806) 743-2340.

Contact Information

Primary practice address
3601 4Th St Suite 3B100 Lubbock TX 79430-0002
Phone: (806) 743-2340
Fax: (806) 743-1775
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 547826 Texas

Profile Details

NPI number 1487690236
LBN Legal business name Latham, Mia
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jul 9th, 2007 - about 18 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 1487690236 NPPES
New Mexico MEDICAID 28759834
New Mexico Other 8Y0080
New Mexico Other 8Y0082

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