Individual
ANDREA JO TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
273 SKIDMORE LN, SUTTON, WV 26601-9272
(304) 765-4400
(304) 765-0354
Mailing address
273 SKIDMORE LN, SUTTON, WV 26601-9272
(304) 765-4400
(304) 765-0354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
105472
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105472
APRN, FNP-C
WV
Enumeration date
09/25/2020
Last updated
08/31/2022
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