Individual
SHELBY J'AUN TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 APPLE STREET, HOUSE, NM 88121
(575) 279-7353
Mailing address
PO BOX 673, HOUSE, NM 88121-0673
(575) 279-7353
(575) 279-6133
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
77902
NM
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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