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General NPI Number Information
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NPI Number | 1306268628
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Entity Type | Individual
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Provider Name | KATI JO TUMA MMS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 1275 SADLER WAY STE 105
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City | FAIRBANKS
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State | AK
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Zip | 99701-3175
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Country | US
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Telephone | 307-267-6150
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Fax | 866-598-2420
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Provider Business Mailing Address
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Address Line | 1314 SHUROS DR
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City | FAIRBANKS
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State | AK
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Zip | 99709-6740
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Country | US
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Telephone | 307-267-6150
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Fax | 866-598-2420
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA586
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 135795
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | TL586
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License Number State | WY
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