TATUM WILSON
NPI 1407788557
Specialist in Saint Louis, MO

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

Active since June 02, 2026

3863 CLEVELAND AVE, SAINT LOUIS, MO 63110(314) 664-3927(314) 664-0556 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tatum Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TATUM WILSON (NPI 1407788557) is an individual specialist in Saint Louis, Missouri and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1407788557

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameTATUM WILSON

Location Address3863 CLEVELAND AVESaint Louis, MO 63110-4009

Mailing Address3863 Cleveland AveSaint Louis, MO 63110-4009 · (314) 664-3927 · Fax (314) 664-0556

Phone(314) 664-3927

Fax(314) 664-0556

Sole ProprietorNo

Enumeration DateJune 2, 2026

NPPES CertifiedJune 2, 2026

✔ NPI 1407788557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3863 CLEVELAND AVE, Saint Louis, MO 63110

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