REXANNA TATLOCK

COLUMBUS, IN
NPI1851877328
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: IN  71008415A)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IN  28204653A)
Enumeration Date2018-07-17
Last Update Date2024-05-17
Business Address
REXANNA TATLOCK AGPCNP-BC
4035 MIMOSA DR
COLUMBUS, IN 47201-7200
Phone number: 812-375-6358
Mailing Address
REXANNA TATLOCK AGPCNP-BC
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800