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Individual
STACEY DAWN TATROE
Active
Individual
STACEY DAWN TATROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN190688
GA
363LF0000X
Family Nurse Practitioner
Primary
RN190688
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003174014E
—
GA
Enumeration date
02/24/2016
Last updated
05/10/2017
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