Individual
KIMBERLY ANNE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4125 LAWNDALE DR, GREENSBORO, NC 27455-1885
(336) 543-0786
(336) 234-5411
Mailing address
219 JUNIPER CREEK BLVD, PINEHURST, NC 28374-6819
(330) 416-3833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005656
NC
363LF0000X
Family Nurse Practitioner
5005656
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006143
—
NC
Enumeration date
06/14/2012
Last updated
09/11/2023
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