Individual
MADISON TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(225) 526-1971
Mailing address
5220 ESSEN LN, BATON ROUGE, LA 70809-3542
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201130
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
201130
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/05/2025
Last updated
01/14/2026
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