Doctor Name: | ERIN E. TANNER |
NPI Number: | 1073920799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN258373 |
Business Practice Address: | 407 Main St Spencer, MA - 015621909 |
Business Phone Number: | 5088859737 |
Business Fax Number: | 5088856139 |
Mailing Address: | 117a Stafford St, WORCESTER |
State: | MA |
Postal Code: | 016031440 |
Phone Number: | 5088541055 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2014 |
NPI Last Update Date: | 09/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN258373 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |