Healthcare Provider Details

I. General information

NPI: 1629271895
Provider Name (Legal Business Name): TATUM H JOHNSON RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CHARLOTTE AVE
NASHVILLE TN
37209-4129
US

IV. Provider business mailing address

2500 CHARLOTTE AVE
NASHVILLE TN
37209-4129
US

V. Phone/Fax

Practice location:
  • Phone: 615-340-0388
  • Fax:
Mailing address:
  • Phone: 615-340-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number137664
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: