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Organization

STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH

Active
Parent organization
STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
Authorized official
DAJUNA LYNN TATOM CRNP (NURSE PRACTITIONER)
(334) 335-2471
Entity
Organization

Contact information

Practice address
15 HOSPITAL RD., CRENSHAW CO. HEALTH DEPT, LUVERNE, AL 36049
(334) 335-2471
(334) 335-3795
Mailing address
15 HOSPITAL RD., CRENSHAW CO. HEALTH DEPT, LUVERNE, AL 36049
(334) 335-2471
(334) 335-3795

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-059257
AL

Other

Enumeration date
09/15/2010
Last updated
09/15/2010
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