Individual
MRS. BRANDY RENEE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
5255 BOWER RIDGE DR, CANAL WINCHESTER, OH 43110-8067
(614) 364-1790
Mailing address
5255 BOWER RIDGE DR, CANAL WINCHESTER, OH 43110-8067
(614) 364-1790
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
33980
WV
164W00000X
Licensed Practical Nurse
Primary
PN.151620-M-IV
OH
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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