Elizabeth G. Latham, F.N.P.-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN067045/AP0855 Issued in AZ

Practice address

467 Vista Ave.
Page, AZ 86040-1625

Phone

(928) 645-8123

Fax

(928) 645-3862

NPI assigned

Mar 8, 2006

Last updated

Jun 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canyonlands Community Health Care

  dba Kaibeto Clinic

  • Federally Qualified Health Center (FQHC)
  • Kaibeto, AZ
  • NPI 1568430676
  Authorized official Same address or phone
• Canyonlands Community Health Care

  dba Canyonlands Urgent Care

  • Community Health Clinic/Center
  • Page, AZ
  • NPI 1669441564
  Authorized official Same address or phone
• Canyonlands Community Healthcare - BH

  • Clinical Psychologist
  • Page, AZ
  • NPI 1558609222
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1114995123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1625",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-9675",
            "fax_number": "928-645-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 VISTA AVE.",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-8123",
            "fax_number": "928-645-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "ELIZABETH",
        "middle_name": "G.",
        "credential": "F.N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN067045/AP0855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645252",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Lynn Kolnik, CRNA
• Lindsey Rae Kozlowski, OTR/L
• Raymond Kwok
• Lake Powell Dental Center, PC
• Matthew Aaron Lasslo
• Andrew Lewandowski, PHARMD
• Julie A Lindholm, MD
• Christopher Linskey, M.D.
• Mark Longo, RPH
• John W. Loosle, MSW

• Family Nurse Practitioner in Page, AZ
• Providers in Page, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.