Provider Demographics
NPI:1740962646
Name:TATUM-ROBERTS, LATAZHANE
Entity type:Individual
Prefix:
First Name:LATAZHANE
Middle Name:
Last Name:TATUM-ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 SHERMAN CT
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1606
Mailing Address - Country:US
Mailing Address - Phone:330-217-2420
Mailing Address - Fax:
Practice Address - Street 1:260 SHERMAN CT
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1606
Practice Address - Country:US
Practice Address - Phone:330-217-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant