Tatlock, Rexanna

Tatlock, Rexanna is an individual health care provider with primary practice located at 4035 Mimosa Dr , Columbus IN 47201-7200. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Tatlock, Rexanna can be contacted via phone (812) 375-6358.

Contact Information

Primary practice address
4035 Mimosa Dr Columbus IN 47201-7200
Phone: (812) 375-6358
Fax: (812) 375-6373
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28204653A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71008415A Indiana

Profile Details

NPI number 1851877328
LBN Legal business name Tatlock, Rexanna
Credentials AGPCNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2018
Last updated May 17th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851877328 NPPES
Indiana Other 000001214853 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 300021975 ANTHEM PROVIDER NUMBER

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