Individual provider · Type 1 NPI

Wanda Nicole Tatum

Driver · Cortland, IL

NPI number 1174335004 Active

Practice location

95 W Meadow Dr
Cortland, IL 60112-4230

Call (312) 307-1651 Map

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XT35091465782 (IL)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

About NPI 1174335004

Wanda Nicole Tatum's National Provider Identifier is 1174335004, issued on Jan 27, 2025. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Cortland, IL. The record was last updated on Jan 27, 2025.