NPI 1396410726
Dominique Tatum
Practice location
- Address
- 2644 Conklin Dr APT 1, Rockford, IL 61101-1865
- Phone
- (815) 713-5685
Registered specialties
Nurse's Aide
Primary
Registry record
- NPI
- 1396410726
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 9 Aug 2021
- Record last updated
- 9 Aug 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.