| Doctor Name: | ELIZABETH G. LATHAM |
| NPI Number: | 1114995123 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P.-C |
| License Number: | RN067045/AP0855 |
| Business Practice Address: | 467 Vista Ave. Page, AZ - 860401625 |
| Business Phone Number: | 9286458123 |
| Business Fax Number: | 9286453862 |
| Mailing Address: | Po Box 1625, PAGE |
| State: | AZ |
| Postal Code: | 860401625 |
| Phone Number: | 9286459675 |
| Fax Number: | 9286452626 |
| NPI Enumeration Date: | 03/08/2006 |
| NPI Last Update Date: | 06/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN067045/AP0855 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |