Latisha Patten, CPNP-PC
Individual provider Active NPI Pediatric Nurse Practitioner · West Point, GA
NPI 1720613243 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1720613243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 3-001326 (AL)
- Practice address
- 1508 Higgins Cir
West Point, GA 31833-3444 - Phone
- (706) 518-7034
- NPI assigned
- Mar 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240209003713 | AL | Practitioner - Nurse Practitioner | 5193168748 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-158365 | AL | MD | Registered Nurse |
| RN222762 | GA | MD | Registered Nurse |
| 3-001326 | AL | MD | Pediatric Nurse Practitioner |
| 222762 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Services Inc | Multi-Specialty | Current | Accepting new patients |
| Health Services, Inc. | Current |
Accepting new patients | |
| Health Services Inc | Current |
Accepting new patients | |
| Health Services Inc | Past | Accepting new patients |
Locations
2611 Woodley Park Dr
Montgomery, AL 36116
Phone (334) 288-0009
2905 E South Blvd
Ste 53
Montgomery, AL 36116
Phone (334) 288-0009
Interoperability endpoints
- latisha.patten.1@14429.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN222762 | GA | |
| Registered Nurse | 163W00000X | 1-158365 | AL | |
| Pediatric Nurse Practitioner |
363LP0200X | 222762 | GA | |
| Pediatric Nurse Practitioner | 363LP0200X | 3-001326 | AL | Yes |
Addresses
Primary practice location
1508 Higgins Cir
West Point, GA 31833-3444
Mailing address
1508 Higgins Cir
West Point, GA 31833-3444
Phone (706) 518-7034
Other providers in West Point, GA
- Laboratory Corporation of America Holdings
- Monica Mothershed
- Nolan Dental LLC
- James W. Parker
- Pathways Center for Behavioral and Developmental Growth
- Conner Millwood Robbins
- Chassidy Mercedes Russell
- Payal Shroff
- Viviane St.Cloud-Noel
- Stafford Medical Transportation LLC
All providers in West Point, GA · Pediatric Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.