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Individual

DOROTHY TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
411 W TIPTON ST, SEYMOUR, IN 47274-2363
(812) 522-2349
Mailing address
411 W TIPTON ST, SEYMOUR, IN 47274-2363
(812) 522-2349

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A0499114
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200322350
IN
Enumeration date
07/27/2006
Last updated
04/13/2010
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