Individual
SHARESA SHONT'E TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3940 EL PASO ST, BEAUMONT, TX 77703-2750
(409) 225-1347
Mailing address
3940 EL PASO ST, BEAUMONT, TX 77703-2750
(409) 225-1347
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
10033458
AR
376K00000X
Nurse's Aide
Primary
10033458
AR
Other
Enumeration date
12/29/2012
Last updated
12/29/2012
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