Prescott, Lateisha

Prescott, Lateisha is an individual health care provider with primary practice located at 34700 Valley Rd , Oconomowoc WI 53066-4599. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Prescott, Lateisha can be contacted via phone (262) 646-4411.

Contact Information

Primary practice address
34700 Valley Rd Oconomowoc WI 53066-4599
Phone: (262) 646-4411
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 176126-30 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 10005-33 Wisconsin

Profile Details

NPI number 1609410364
LBN Legal business name Prescott, Lateisha
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2019
Last updated Jul 10th, 2020 - about 4 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 1609410364 NPPES
Wisconsin MEDICAID 1609410364

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