Individual
TIA MARIE CARNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(419) 783-2200
Mailing address
18095 DEFIANCE PAULDING COUNTY LINE ROAD, DEFIANCE, OH 43512
(419) 438-6250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
422912
OH
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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