Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WANDA NICOLE TATUM
ActiveWANDA NICOLE TATUM is a Driver healthcare provider located in CORTLAND, Illinois. NPI 1174335004 is currently active in the NPPES registry. Verify at CMS.
Driver · CORTLAND, IL
Registration Details
- NPI Number
- 1174335004
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 27, 2025 (1.5250582476863 yrs)
- Last Updated
- Jan 27, 2025
- License
-
T35091465782 (IL)
Practice Information
- Address
-
95 W MEADOW DRCORTLAND, IL, 601124230Browse IL providers · Browse ZIP 60112
- Phone
- 3123071651
- Primary Specialty
-
Driver
172A00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.