| Doctor Name: | DAJUNA TATOM |
| NPI Number: | 1255649992 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.R.N.P. |
| License Number: | 1-059257 |
| Business Practice Address: | 15 Hospital Dr Luverne, AL - 360497341 |
| Business Phone Number: | 3343352471 |
| Business Fax Number: | 3343353795 |
| Mailing Address: | 201 Monroe St, Suite 1386 MONTGOMERY |
| State: | AL |
| Postal Code: | 361043735 |
| Phone Number: | 3342067959 |
| Fax Number: | 2334206399 |
| NPI Enumeration Date: | 09/15/2010 |
| NPI Last Update Date: | 09/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1-059257 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |