Individual ProviderTarah ChathamNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6798 Us Highway 98 Suite 30, Hattiesburg, MS 39402(601) 596-9053PECOS EnrollmentBased on the most recent information from CMS, provider Tarah Chatham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1811355605Provider TypeIndividualFull NameChatham, TarahCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date2/8/2016Last Updated2/14/2025Contact InformationPractice LocationPractice Address6798 Us Highway 98 Suite 30, Hattiesburg, MS 39402Phone(601) 596-9053Fax(601) 336-6615Mailing LocationMailing Address6798 Highway 98 Suite 30, Hattiesburg, MS 39402Phone(601) 596-9053FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense901435MississippiCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense901435MississippiProvider IdentifiersIDDescriptionIssuerID06158839DescriptionMedicaidIssuerUnlistedMississippi