MEDICARE: ASHLEY TANNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1831042761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY TANNER

Provider Business Mailing Address
First Line	:	273 MAGNOLIA RD
Second Line	:
City	:	SALEM
State	:	AR
Zip	:	72576-9604
Country	:	US
Telephone Number	:	870-625-0273
Fax Number	:	870-625-0275

Provider Business Practice Location Address
First Line	:	273 MAGNOLIA RD
Second Line	:
City	:	SALEM
State	:	AR
Zip	:	72576-9604
Country	:	US
Telephone Number	:	870-625-0273
Fax Number	:	870-625-0275

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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Directions to “ ASHLEY TANNER ” Practice Location

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