Individual provider · Type 1 NPI

Latasha Wiley

Family Nurse Practitioner · Jacksonville, FL

NPI number 1821628207 Active

Practice location

4280 Southside Blvd
Jacksonville, FL 32216-5400

Fax (904) 998-4027

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XAPRN11005781 (FL)

Family Nurse Practitioner: Definition to come...

15 other providers at this address

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About NPI 1821628207

Latasha Wiley's National Provider Identifier is 1821628207, issued on Jan 24, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Jacksonville, FL. The record was last updated on Jun 22, 2026.