| Tymber Lee Tatum Arnp, Llc | |
|
426 Sw Commerce Dr Ste 105 Lake City FL 32025-1506 | |
| (386) 247-1295 | |
| Not Available |
| Full Name | Tymber Lee Tatum Arnp, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 426 Sw Commerce Dr Ste 105, Lake City, Florida |
| Authorized Official Name and Position | Tymber Tatum Terrell (OWNER) |
| Authorized Official Contact | 3862471295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tymber Lee Tatum Arnp, Llc 2556 Nw 216th St Lawtey FL 32058-4101 Ph: (386) 247-1295 | Tymber Lee Tatum Arnp, Llc 426 Sw Commerce Dr Ste 105 Lake City FL 32025-1506 Ph: (386) 247-1295 |
| NPI Number | 1265204226 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 10/24/2023 |
| Medicare PECOS PAC ID | 6103274071 |
|---|---|
| Medicare Enrollment ID | O20231204000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265204226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tymber Tatum Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861018988 PECOS PAC ID: 3779979257 Enrollment ID: I20220410000102 |
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