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NPI Code Detail

MEDICARE: TANNER CUTRELL

MEDICARE: TANNER CUTRELL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1740012640
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANNER CUTRELL
Provider Business Mailing Address
First Line : 770 PARK CENTRE DR
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-3598
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 770 PARK CENTRE DR
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-3598
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 02/08/2026

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1851991459 — AMBER WALKER
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KERNERSVILLE, NC
27284-3598
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1750982641 — MR. MAURICE ANTONIO BROWN
Practice Location Address:
770 PARK CENTRE DR
KERNERSVILLE, NC
27284-3598
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Practice Fax: 704-788-2016

Directions to “ TANNER CUTRELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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