Latena Montgomery-Booker, RN

Individual provider Active NPI Case Management Registered Nurse · Ovilla, TX

NPI 1245929256 · NPPES record last updated May 4, 2023

Key facts

NPI
1245929256
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
796850 (TX)
Practice address
6960 Cedar CT
Ovilla, TX 75154-3342
Phone
(405) 210-4390
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
796850TXMDInfection Control Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 796850 TX
Infection Control Registered Nurse 163WI0600X 796850 TX
Wound Care Registered Nurse 163WW0000X 796850 TX
Case Management Registered Nurse 163WC0400X 796850 TX Yes

Addresses

Primary practice location

6960 Cedar CT
Ovilla, TX 75154-3342

Mailing address

6960 Cedar CT
Ovilla, TX 75154-3342
Phone (405) 210-4390

Other providers in Ovilla, TX

All providers in Ovilla, TX · Case Management Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.