Christen Stacy Tatum, PHARM D
Individual provider Active NPI Pharmacist · Mayodan, NC
NPI 1346644663 · NPPES record last updated Oct 15, 2014
Key facts
- NPI
- 1346644663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 22402 (NC)
- Practice address
- 6711 NC Highway 135
Mayodan, NC 27027-8487 - Phone
- (336) 548-2737
- NPI assigned
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22402 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22402 | NC | Yes |
Addresses
Primary practice location
6711 NC Highway 135
Mayodan, NC 27027-8487
Mailing address
6711 NC Highway 135
Mayodan, NC 27027-8487
Phone (336) 548-2737
Other providers in Mayodan, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.