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1437231016 NPI number — HEIDI RENEE TANNER RPH

NPI Number: 1437231016
Health Care Provider/Practitioner: HEIDI RENEE TANNER RPH

Information about “1437231016” NPI (HEIDI RENEE TANNER RPH) exists in 1437231016 in HTML format HTML  |  1437231016 in plain Text format TXT  |  1437231016 in PDF (Portable Document Format) PDF  |  1437231016 in an XML format XML  formats.

NPI Number : 1437231016 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437231016",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TANNER",
    "FirstName": "HEIDI",
    "MiddleName": "RENEE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RPH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VINT",
    "OtherFirstName": "HEIDI",
    "OtherMiddleName": "R",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "207 N DIXON RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KOKOMO",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46901-4131",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "765-452-9000",
    "MailingAddressFaxNumber": "765-452-9633",
    "FirstLinePracticeLocationAddress": "201 N DIXON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KOKOMO",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46901-4097",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "765-457-1191",
    "PracticeLocationAddressFaxNumber": "765-868-3184",
    "EnumerationDate": "10/20/2006",
    "LastUpdateDate": "08/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "26020973A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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