Vick, Latasha

Vick, Latasha is an individual health care provider with primary practice located at 2990 Military Ave , Baxter Springs KS 66713-2331. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Vick, Latasha can be contacted via phone (620) 856-2900.

Contact Information

Primary practice address
2990 Military Ave Baxter Springs KS 66713-2331
Phone: (620) 856-2900
Fax: (620) 856-2901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1061723 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1061723 Oklahoma
Dental Providers / General Practice 1223G0001X 61068 Kansas

Profile Details

NPI number 1669456364
LBN Legal business name Vick, Latasha
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Aug 20th, 2013 - about 12 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 1669456364 NPPES
Oklahoma Other 1061723 PA LICENSE
Oklahoma MEDICAID 200022980B PA LICENSE
Oklahoma MEDICAID 200022980C PA LICENSE

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