Organization
TANNER MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE SLOAN GRAHAM FNP-C (VP OF OPERATIONS)
(256) 432-2822
Entity
Organization
Contact information
Practice address
20104 SWANNER BLVD, SUITE 4, TANNER, AL 35671-3651
(256) 686-3334
(256) 686-3339
Mailing address
20104 SWANNER BLVD, TANNER, AL 35671-3651
(256) 686-3334
(256) 686-3339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
AL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159174
—
AL
Enumeration date
01/18/2013
Last updated
05/23/2023
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