Mathis, Kemisha Latoya

Mathis, Kemisha Latoya is an individual health care provider with primary practice located at 2279 W 2Nd St , Jacksonville FL 32209-6906. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Homemaker, Nursing Service Related Providers / Nursing Home Administrator. Nursing Service Related Providers / Homemaker is her primary health care specialty. Mathis, Kemisha Latoya can be contacted via phone (850) 851-6363.

Contact Information

Primary practice address
2279 W 2Nd St Jacksonville FL 32209-6906
Phone: (850) 851-6363
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Homemaker 376J00000X 238188 Florida
Nursing Service Related Providers / Nursing Home Administrator 376G00000X

Profile Details

NPI number 1073147914
LBN Legal business name Mathis, Kemisha Latoya
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2020
Last updated Dec 28th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1073147914 NPPES
Florida MEDICAID 47-4268046

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