Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Latasha Deree Hines, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1245014299

Latasha Deree Hines, AGACNP is a Nurse Practitioner in Raleigh, North Carolina. Qualified in 2019, 7 years ago. Practices with North Carolina Mg LLC, a 712-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone: (919) 784-2100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 5018669 (NC)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence HINE-3CL25 (NC)

Record details

NPI number1245014299
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedAugust 22, 2023
Last updated in NPPESNovember 27, 2023
Certification dateNovember 27, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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