Individual
KIM TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9454 DEL WEBB BLVD, LAS VEGAS, NV 89134-8314
(702) 940-1580
(702) 940-1581
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN002919
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073005419
—
NV
01
—
APRN002919
STATE LICENSE
NV
Enumeration date
06/01/2018
Last updated
10/20/2022
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