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Individual
MISTY DAWN TATOM
Active
Individual
MISTY DAWN TATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
894413
TX
363LF0000X
Family Nurse Practitioner
Primary
1108433
TX
363LF0000X
Family Nurse Practitioner
AP61530730
WA
Other
Enumeration date
01/05/2023
Last updated
06/24/2024
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