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General NPI Number Information
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NPI Number | 1194159491
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Entity Type | Individual
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Provider Name | TINA A TANNER
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 1237 GARDEN ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-2929
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Country | US
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Telephone | 740-252-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 1237 GARDEN ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-2929
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Country | US
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Telephone | 740-252-7011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1744R1102X
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Taxonomy Name | Research Study Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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