Individual
AMY BIDWELL TATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP
Contact information
Practice address
2065 NE TUCSON WAY APT 110, BEND, OR 97701-5182
(541) 383-3005
(541) 383-1883
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 548-2164
(541) 548-0534
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201250129NP
OR
Other
Enumeration date
08/28/2012
Last updated
10/09/2024
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