Provider Demographics
NPI:1770462830
Name:ANDERSON, LATRISHA T
Entity type:Individual
Prefix:MRS
First Name:LATRISHA
Middle Name:T
Last Name:ANDERSON
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 1:6309 Y ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2264
Mailing Address - Country:US
Mailing Address - Phone:402-217-8002
Mailing Address - Fax:
Practice Address - Street 1:6309 Y ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2264
Practice Address - Country:US
Practice Address - Phone:402-217-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant