Individual
SHAYLON TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN IV
Contact information
Practice address
295 SUMMAR DR, JACKSON, TN 38301-3905
(731) 421-6783
Mailing address
219 W BROAD ST, DYER, TN 38330-1403
(731) 337-8363
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000065644
TN
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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