Individual
TATUM NICOLE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
Mailing address
1319 EMERALD DR, NILES, MI 49120-4524
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
28254591A
IN
Other
Enumeration date
10/25/2025
Last updated
10/25/2025
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