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Individual

MR. ERIC TATUM JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
901 SAINT MARYS DR STE 300, EVANSVILLE, IN 47714-0521
(812) 473-2642
Mailing address
5859 PEMBERLY CT, NEWBURGH, IN 47630-4504

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
PENDING
IN

Other

Enumeration date
07/29/2020
Last updated
07/29/2020
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