Individual
MRS. DIANA JUNE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2007 OCILLA RD, DOUGLAS, GA 31533-2229
(912) 384-0162
Mailing address
2007 OCILLA RD, DOUGLAS, GA 31533-2229
(912) 384-0162
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN225362
GA
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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