Healthcare Provider Details

I. General information

NPI: 1003773623
Provider Name (Legal Business Name): TATUM KAY WINDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W 1325 N
CEDAR CITY UT
84721-7720
US

IV. Provider business mailing address

276 N 800 W APT 4
CEDAR CITY UT
84721-4325
US

V. Phone/Fax

Practice location:
  • Phone: 435-586-6481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226000000X
TaxonomyRecreational Therapist Assistant
License Number227962230
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: