| Doctor Name: | KERI TATUM |
| NPI Number: | 1467840629 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP127123 |
| Business Practice Address: | 227 Memorial Dr Gatesville, TX - 765281028 |
| Business Phone Number: | 2542486500 |
| Business Fax Number: | 2542386594 |
| Mailing Address: | 227 Memorial Dr, GATESVILLE |
| State: | TX |
| Postal Code: | 765281028 |
| Phone Number: | 2542486500 |
| Fax Number: | 2542386594 |
| NPI Enumeration Date: | 12/22/2014 |
| NPI Last Update Date: | 12/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP127123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |