MRS. VICTORIA RENEE LATHAM (NPI# 1720638190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720638190 |
| Entity Type | Individual |
| Full Name | MRS. VICTORIA RENEE LATHAM |
| Credential | FNP-C |
| Practice Address |
1276 Gilbreath Dr Johnson City TN 37614 |
| Mailing Address |
126 Isaiah Ln Powell TN 37849-7656 |
| Practice Telephone | 8659649816 |
| Mailing Telephone | 8659649816 |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | F09190092 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1276 GILBREATH DR |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497295711 | Charles Faust | Dental Hygienist | 1276 Gilbreath Dr, Johnson City, TN 37614 | 2017-03-06 |
| 1124642582 | Amanda Lane Mccurry | Registered Nurse | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2020-06-02 |
| 1063036671 | Rashid Mahmood Qureshi | Pathology | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2020-05-31 |
| 1548805807 | Nathan Benjamin Barger | Specialist/Technologist | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2019-11-11 |
| 1588209852 | Caitlyn Harter | Specialist/Technologist | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2019-11-11 |
| 1578107280 | Brett Lewis | Specialist/Technologist | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2019-11-05 |
| 1104488626 | Tiffany Danielle Holt | Nurse Practitioner | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2019-07-04 |
| 1982175501 | Pammela Marie Poore | Nurse Practitioner | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2018-12-07 |
| 1306333513 | Deep Kalariya | Student in an Organized Health Care Education/Training Program | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2018-04-13 |
| 1609373984 | Sri Pallavi Morampudi | Student in an Organized Health Care Education/Training Program | 1276 Gilbreath Dr, Johnson City, TN 37614-6503 | 2018-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467061887 | Jessica Marie Robinson | Pharmacist | Maple Avenue Building 7, Johnson City, TN 37614 | 2020-07-31 |
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1326682493 | Yoshihiro Kojima | Specialist/Technologist | 127 W John Robert Bill Dr, Johnson City, TN 37614 | 2019-11-01 |
| 1205360104 | Charlotte Lynn Alexander | Student in an Organized Health Care Education/Training Program | Department of Obstetrics and Gynecology, 70569, Qcom Building 1, Room 307, Johnson City, TN 37614 | 2017-04-18 |
| 1679006787 | Joel Whipple | Student in an Organized Health Care Education/Training Program | Etsu - Building 1, 2nd Floor, Johnson City, TN 37614 | 2017-04-05 |
| 1265889414 | Dyan Darang | Student in an Organized Health Care Education/Training Program | Etsu, Quillen College of Medicine, Psychiatry Residency Program, Box 70567, Johnson City, TN 37614 | 2016-05-18 |
| 1194170142 | Katharine Ann Lasher | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, Dogwood Ave, Building 1, Rm 249, East Tennessee State Univ. Quillen College of Medicine, Johnson City, TN 37614 | 2016-04-27 |
| 1992150189 | Nishika Shina Moradia | Student in an Organized Health Care Education/Training Program | East Tennessee State University Quillen College of Medi, Dogwood Ave, Building 1, Room 249, Johnson City, TN 37614 | 2016-04-26 |
| 1962884429 | Apurva Bansal | Student in an Organized Health Care Education/Training Program | 325 North State of Franklin, Johnson City, TN 37614 | 2015-06-22 |
| 1760877740 | Adrienne Griffin | Student in an Organized Health Care Education/Training Program | Dogwood Avenue, Building 1, Room 249, Johnson City, TN 37614 | 2015-04-06 |
| Find all providers in zip 37614 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205468923 | Bobby Ray Nichols IIi | Nurse Practitioner | 2708 S Greenwood Dr, Johnson City, TN 37604-3260 | 2020-02-11 |
| 1932748829 | Shape Shifters Weight Loss and Joint Center | Nurse Practitioner | 104 University Pkwy Ste 1, Johnson City, TN 37604-7349 | 2019-12-26 |
| 1205484920 | Violetta Ward | Nurse Practitioner | 1505 Chickees St, Johnson City, TN 37604-7102 | 2019-08-27 |
| 1972077816 | Betty Christian Kinser | Nurse Practitioner | 3135 Peoples St Ste 303, Johnson City, TN 37604-4130 | 2019-01-14 |
| 1912489261 | Casey Lynn Davis | Nurse Practitioner | 208 Sunset Dr Ste 340, Johnson City, TN 37604-2521 | 2018-09-04 |
| 1356831101 | Sheena L Tullock | Nurse Practitioner | 2428 Knob Creek Rd Ste 102, Johnson City, TN 37604-2396 | 2018-05-17 |
| 1093212516 | Brandy Michelle Story | Nurse Practitioner | 1321 Sunset Dr Ste 11, Johnson City, TN 37604-7902 | 2018-04-11 |
| 1265959316 | Ashley Gross | Nurse Practitioner | 411 Princeton Rd Ste 101, Johnson City, TN 37601-2049 | 2017-08-29 |
| 1114454857 | Janet Gar | Nurse Practitioner | 1319 Bell Ridge Rd Apt 703, Johnson City, TN 37601-8021 | 2017-05-12 |
| 1720527674 | Kristina Bagley | Nurse Practitioner | 101 Medtech Parkway, Suite 200, Johnson City, TN 37604-4007 | 2017-02-13 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37614 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.