Basic Information
| Provider Information | |||||||||
| NPI: | 1376736694 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARUTI | ||||||||
| FirstName: | LATOSHIA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10 | ||||||||
| Address2: | |||||||||
| City: | MASON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488540010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5176769788 | ||||||||
| FaxNumber: | 5176763438 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 E BELLEVUE ST | ||||||||
| Address2: | |||||||||
| City: | LESLIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492519373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175898252 | ||||||||
| FaxNumber: | 5175895189 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 05/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 4704152658 | MI | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 4704152658 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.