Individual provider · Type 1 NPI

Nicole Latgis, PA-C

Surgical Physician Assistant · Murray, UT

NPI number 1194398800 Active

Practice location

5121 S Cottonwood St
Murray, UT 84107-5701

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Surgical Physician Assistant Primary 363AS0400X25MP00641600 (NJ)
Physician Assistant 363A00000X25MP00641600 (NJ)
Physician Assistant 363A00000X13698599-1206 (UT)

Surgical Physician Assistant: Definition to come...

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About NPI 1194398800

Nicole Latgis, PA-C's National Provider Identifier is 1194398800, issued on Jul 20, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Murray, UT. The record was last updated on Mar 27, 2026.