Provider Demographics
NPI:1164689410
Name:SEWELL, LATOYA S (CRNP)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:S
Last Name:SEWELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:F
Other - Last Name:STUCKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5457 TWIN KNOLLS RD STE 300-1274
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3259
Mailing Address - Country:US
Mailing Address - Phone:443-459-1624
Mailing Address - Fax:866-485-2859
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 300-1274
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3259
Practice Address - Country:US
Practice Address - Phone:443-459-1624
Practice Address - Fax:866-485-2859
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157845363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily