Provider Demographics
NPI:1407740723
Name:WARREN, LATASHA DENISE
Entity type:Individual
Prefix:MS
First Name:LATASHA
Middle Name:DENISE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 ROADSIDE LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-4667
Mailing Address - Country:US
Mailing Address - Phone:757-618-3723
Mailing Address - Fax:757-586-3407
Practice Address - Street 1:2619 ROADSIDE LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-4667
Practice Address - Country:US
Practice Address - Phone:757-618-3723
Practice Address - Fax:757-586-3407
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-0005863374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide