| Organization Name: | STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH |
| NPI Number: | 1376851162 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAJUNA LYNN TATOM (NURSE PRACTITIONER) |
| Mailing Address: | 15 Hospital Rd. Crenshaw Co. Health Dept Luverne |
| State: | AL US |
| Postal Code: | 36049 |
| Phone Number: | 3343352471 |
| Fax Number: | 3343353795 |
| 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: | |