Individual
BRENDA K TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BSN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(931) 220-1459
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(931) 220-1459
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN0000096667
TN
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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