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NPI Code Detail

MEDICARE: DEBORAH S TANNER

MEDICARE:   DEBORAH S 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
1172A00000XDriver
23747P1801XPersonal Care Attendant
3376J00000XHomemaker

General Provider Information

NPI Number : 1205519428
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH S TANNER
Provider Business Mailing Address
First Line : 6230 CREEK LAKE CT
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-8178
Country : US
Telephone Number : 513-227-9348
Fax Number :
Provider Business Practice Location Address
First Line : 6230 CREEK LAKE CT
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-8178
Country : US
Telephone Number : 513-227-9348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ DEBORAH S TANNER ” Practice Location

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