MS. SHANNON LEE LATHAM


Address: 801 S Rancho Dr Ste F1, Las Vegas, NV 89106-3814
Phone: 7024744454

MS. SHANNON LEE LATHAM (NPI# 1467912386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467912386
Entity Type Individual
Full Name MS. SHANNON LEE LATHAM
Credential APRN, FNP-C
Practice Address 801 S Rancho Dr Ste F1
Las Vegas
NV 89106-3814
Mailing Address 1022 Shades End Ave
North Las Vegas
NV 89081-3316
Practice Telephone 7024744454
Practice Fax Number 7024744424
Mailing Telephone 7029083943
Enumeration Date 2019-03-25
Last Update Date 2019-03-25
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
816577 NV Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 801 S RANCHO DR STE F1
City LAS VEGAS
State NV
Zip Code 89106-3814

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NPI Name Taxonomy Address Enumeration
1417555772 Graciela Miranda Cocorpio Technician 820 Rancho Ln Suite #40, Las Vegas, NV 89106 2020-10-09
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1730725177 Mariah La'neese Jones Rehabilitation Practitioner 400 Shadow Lane Ste 106, Las Vegas, NV 89106 2019-11-20
1417592841 Lourdes Rita Apumayta-paredes Technician 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 2019-11-08
1902456551 Marisela Pena Technician 820 Rancho Ln., 25, Las Vegas, NV 89106 2019-09-16
1992368724 Amber Nicole Mahajan Nurse Practitioner 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 2019-04-17
1568924215 Arlandrea Tarvins Behavioral Analyst 1048 Miller Ave, Las Vegas, NV 89106 2019-04-02
1427510361 Erik Pennell Student in an Organized Health Care Education/Training Program 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 2019-04-01
1245702729 Bruce Mark Babb Technician 820 Rancho Lane Ste #40, Las Vegas, NV 89106 2018-12-21
1639649213 Antonio Ruiz Pelfort Technician 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 2018-11-27
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City LAS VEGAS
Zip Code 89106

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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