Latasha Blue
Individual provider Active NPI Driver · Grifton, NC
NPI 1366086282 · NPPES record last updated Nov 4, 2019
Key facts
- NPI
- 1366086282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 25441176 (NC)
- Practice address
- 313 Olive Branch Blvd
Grifton, NC 28530-8584 - Phone
- (252) 531-3100
- NPI assigned
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25441176 | NC | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solid Transport Solutions Inc | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 25441176 | NC | Yes |
Addresses
Primary practice location
313 Olive Branch Blvd
Grifton, NC 28530-8584
Mailing address
PO Box 31032
Greenville, NC 27833-1032
Phone (252) 414-0999
Other providers in Grifton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.