Individual
MR. CHRISTIAN DALE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
5001 LAKE AVE, SAINT JOSEPH, MO 64504-1170
(816) 238-7788
Mailing address
18400 SE HIGHWAY 371, DEARBORN, MO 64439-8161
(816) 210-6360
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017035200
MO
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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