Individual
KIRK W TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-0000
Mailing address
PO BOX 800778, CHARLOTTESVILLE, VA 22908-0778
(434) 982-4228
(434) 924-2078
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024094260
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008933481
—
VA
Enumeration date
06/10/2005
Last updated
09/26/2012
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