Individual provider Active NPI

Latisha Lynnette Underwood, CNA 162719

  • Nurse's Aide
  • Winter Haven, FL
National Provider Identifier
1730084062
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
162719 Issued in FL
Practice address
4079 Mahogany Run
Winter Haven, FL 33884-2931
Phone
(863) 670-5816
NPI assigned
Oct 8, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 162719 FL Primary

Addresses

Primary practice location

4079 Mahogany Run
Winter Haven, FL 33884-2931

Mailing address

4079 Mahogany Run
Winter Haven, FL 33884-2931
Phone (863) 670-5816

Other names 1

  • Latisha Lynnette Worrell Former name

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1730084062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4079 MAHOGANY RUN",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842931",
            "telephone_number": "863-670-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 MAHOGANY RUN",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842931",
            "telephone_number": "863-670-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "LATISHA",
        "middle_name": "LYNNETTE",
        "credential": "CNA 162719",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "162719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATISHA",
            "last_name": "WORRELL",
            "middle_name": "LYNNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.