Individual
SANDERICKA TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1300 BRADEN ST, JACKSONVILLE, AR 72076-3719
(501) 453-6950
Mailing address
1300 BRADEN ST, JACKSONVILLE, AR 72076-3719
(501) 453-6950
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
230744
AR
Other
Enumeration date
02/07/2025
Last updated
05/04/2026
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