Provider Demographics
NPI:1609673979
Name:TATMAN, MICHELLE (RD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:TATMAN
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7383 WINDSOR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9260
Mailing Address - Country:US
Mailing Address - Phone:513-600-9836
Mailing Address - Fax:
Practice Address - Street 1:7383 WINDSOR MEADOW DR
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9260
Practice Address - Country:US
Practice Address - Phone:513-600-9836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.7404133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered