Individual
TABATHA ANN PERREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
21 E STATE ST, COLUMBUS, OH 43215-4281
(574) 546-1900
(574) 546-1999
Mailing address
801 MEDICAL DR STE A, LIMA, OH 45804-4030
(419) 222-6622
(419) 224-0015
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.022605
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.022605
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.022605
STATE LICENSE
OH
Enumeration date
05/21/2018
Last updated
12/09/2024
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