MRS. TAMISHA SLAYTON HODUM


Address: 11100 Highway 64, Bolivar, TN 38008-1554
Phone: 7312282000

MRS. TAMISHA SLAYTON HODUM (NPI# 1083270623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083270623
Entity Type Individual
Full Name MRS. TAMISHA SLAYTON HODUM
Credential APRN, FNP-C
Practice Address 11100 Highway 64
Bolivar
TN 38008-1554
Mailing Address 369 County Road 770
Walnut
MS 38683-8770
Practice Telephone 7312282000
Mailing Telephone 6626431457
Enumeration Date 2019-05-18
Last Update Date 2020-01-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse R879605 MS Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
26473 TN Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
903386 MS Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
369 County Road 770, Walnut, MS 386838770 6626431457

Office Location

Street Address 11100 HIGHWAY 64
City BOLIVAR
State TN
Zip Code 38008-1554

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538114020 State of Tennessee-western Mental Health Institute Psychiatric Hospital 11100 Highway 64, Bolivar, TN 38008-1554 2006-05-23
1295116531 Danielle Whitehurst Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2015-06-12
1104192053 Maggie G. Billings Nurse Practitioner 11100 Highway 64, Bolivar, TN 38008-1554 2012-03-26
1780698548 Vijaya K Chandel Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-07-28
1629012554 Philip H Morson Neuromusculoskeletal Medicine & OMM 11100 Highway 64, Bolivar, TN 38008-1554 2006-06-14
1346281300 Jeffrey M Robbins Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-06-09
1275572877 Hilary F Linder Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-06-06
1750320883 James William Varner Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-06-05
1568418499 Sherwin A Yaffe Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-05-25
1518913102 Janell Joan Batchellor Psychiatry & Neurology 11100 Highway 64, Bolivar, TN 38008-1554 2006-05-25
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720639172 Shanna Shackelford Nurse Practitioner 11100 Old Hwy 64 W, Bolivar, TN 38008 2019-09-26
1598326233 Holly Brooke Shourd Family Medicine 1359 W Market St., Bolivar, TN 38008 2019-06-24
1992299234 Angela Dawn Haynes Registered Nurse 10825 Hwy 64w, Bolivar, TN 38008 2018-06-20
1326595919 Ashley Evon Jowers Nurse Practitioner 11100 Old Hwy 64 West, Bolivar, TN 38008 2016-09-01
1942458344 Anita Pearl Johnson Physical Therapy Assistant 700 Knuckolls Ave, Bolivar, TN 38008 2008-08-28
1841340007 State of Tennessee Public Health or Welfare 10825 Old Hwy 64, Bolivar, TN 38008 2007-01-11
1164479721 Betty Ragon Lenoir Physical Therapist 789 Tennessee St, Bolivar, TN 38008 2006-05-28
1689623050 County of Hardeman Ambulance 735 Naylor St, Bolivar, TN 38008 2006-05-10
1841287109 Michiel Brent Rudder Family Medicine 622 West Market Street, Bolivar, TN 38008 2005-10-03
1982606497 Richard Mast Reinhard IIi Pediatrics 629 Nuckolls Rd, Bolivar, TN 38008 2005-08-15
Find all providers in zip 38008

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457803363 Brandy Yarnell Nurse Practitioner 2520 S Springfield Ave, Bolivar, MO 65613-9691 2016-10-26
1144636119 Gregary Byers Nurse Practitioner 107 Tennessee St, Bolivar, TN 38008-1822 2014-07-10
1780908228 Miracle Healthcare LLC Nurse Practitioner 649b W Mcneal St, Bolivar, TN 38008-2519 2010-03-25
1538273396 Marceleen K. Powell Nurse Practitioner 1120 S Springfield Ave, Bolivar, MO 65613-2512 2006-08-18
1023066057 Tammi L Ferguson Nurse Practitioner 1700 W Market St, Suite J, Bolivar, TN 38008-1653 2006-05-04
1083679104 Oma L Shelton Nurse Practitioner 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 2006-04-20
1750999231 Bethany Martin Nurse Practitioner 1501 N Oakland Ave, Bolivar, MO 65613-3020 2020-07-21
1104474741 Kaylee Jaynelle Ankrom Nurse Practitioner 1300 N Oakland Ave, Bolivar, MO 65613-3018 2019-08-27
1164074175 Courtney Marie Brummel Nurse Practitioner 1120 S Springfield Ave, Bolivar, MO 65613-2512 2019-07-10
1194211664 Olivia Jenae Cumley Nurse Practitioner 1240 N Butterfield Rd, Bolivar, MO 65613-3016 2018-07-07
Find all providers in BOLIVAR

Competitor

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City BOLIVAR
Zip Code 38008

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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