Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 42537 | TN |
N | 207VG0400X | Gynecologist | 42537 | TN |
NPI | 1124226477 |
---|---|
Provider Name | Jennifer M Tatalovich |
First Address | Goodlettsville, TN 37072-3132 |
Second Address | Franklin, TN 37067-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2007 |
Last Update Date | 02/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508987 | (05) | TN |