Healthcare Provider Details
I. General information
NPI: 1144320227
Provider Name (Legal Business Name): JANET ELAINE TATMAN PHD, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 12/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8160 N HAYDEN RD SUITE J-112
SCOTTSDALE AZ
85258-2467
US
IV. Provider business mailing address
8160 N HAYDEN RD SUITE J-112
SCOTTSDALE AZ
85258-2467
US
V. Phone/Fax
- Phone: 480-905-8755
- Fax: 480-905-8851
- Phone: 480-905-8755
- Fax: 480-905-8851
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 1946 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 3052 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: