# HEATHER L TATUM APRN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558182428
- **Authorized official:** HEATHER L TATUM APRN (OWNER)
- **Authorized official phone:** (850) 209-5883

## Contact information

- **Practice address:** 4215 KELSON AVE, SUITE E, MARIANNA, FL 32446
- **Practice address phone:** (850) 526-3434
- **Mailing address:** 4984 BUTTON LANE, MARIANNA, FL 32448
- **Mailing address phone:** (850) 209-5883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/22/2024
- **Last updated:** 10/22/2024