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General NPI Number Information
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NPI Number | 1972403731
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Entity Type | Individual
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Provider Name | JENINE TANNER RN, BSN, BA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 4691 WINDFALL RD
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City | MEDINA
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State | OH
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Zip | 44256-8705
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Country | US
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Telephone | 330-725-7751
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Fax |
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Provider Business Mailing Address
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Address Line | 1097 GREENWOOD CT
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City | MEDINA
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State | OH
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Zip | 44256-4120
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Country | US
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Telephone | 330-723-6393
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.328950
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License Number State | OH
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