Individual
DARVIN RICKEY TANNER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
126 WALT TANNER RD, LUCEDALE, MS 39452-4128
(601) 508-5487
Mailing address
126 WALT TANNER RD, LUCEDALE, MS 39452-4128
(601) 508-5487
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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