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General NPI Number Information
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NPI Number | 1891518833
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Entity Type | Individual
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Provider Name | TANNER R PURNHAGEN APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-1900
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Country | US
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Telephone | 216-444-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 184 CIDER MILL LN
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City | BRUNSWICK
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State | OH
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Zip | 44212-1526
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Country | US
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Telephone | 703-623-8078
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0038674
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License Number State | OH
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