Individual
KIMBERLY TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
899 AIGNER DR, BOONVILLE, IN 47601-8473
(812) 641-0262
Mailing address
899 AIGNER DR, BOONVILLE, IN 47601-8473
(812) 641-0262
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28180231A
IN
Other
Enumeration date
01/09/2020
Last updated
04/02/2025
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