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Individual

TARAH CHATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
6798 US HIGHWAY 98 SUITE 30, HATTIESBURG, MS 39402
(601) 596-9053
(601) 336-6615
Mailing address
6798 HIGHWAY 98 SUITE 30, HATTIESBURG, MS 39402
(601) 596-9053

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
901435
MS
363LF0000X
Family Nurse Practitioner
Primary
901435
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06158839
MS
Enumeration date
02/08/2016
Last updated
02/14/2025
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