Provider Demographics
NPI:1871483792
Name:TATUM, CALLEIGH
Entity type:Individual
Prefix:
First Name:CALLEIGH
Middle Name:
Last Name:TATUM
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 1:2000 P ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3630
Mailing Address - Country:US
Mailing Address - Phone:531-220-2628
Mailing Address - Fax:402-477-0725
Practice Address - Street 1:2000 P ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-3630
Practice Address - Country:US
Practice Address - Phone:531-220-2628
Practice Address - Fax:402-477-0725
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator