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Matthew Jason Tanner
Psychiatric/Mental Health Nurse Practitioner in Logansport, Indiana
NPI 1396395067

Matthew Jason Tanner is a Psychiatric/Mental Health Nurse Practitioner based in Kokomo, IN and is specialized in Psychiatric/Mental Health. Matthew Jason Tanner practices in Logansport, IN. The NPI Number for Matthew Jason Tanner is 1396395067 and holds a License No. 28177692A (Indiana).

The current practice location address for Matthew Jason Tanner is 1015 Michigan Ave, Logansport, IN and can be reached out via phone at 574-722-5151.

Location: 1015 Michigan Ave, Logansport, IN, 46902-7506
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396395067
Provider Name
Matthew Jason Tanner
Credential
Provider Entity Type
Individual
Gender
Male
Address
1015 Michigan Ave, Logansport, IN, 46902-7506
Phone Number
574-722-5151
Fax Number
Provider Enumeration Date
09/16/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1015 Michigan Ave
City
Logansport
State
Indiana
Zip
46947-1526
Phone Number
574-722-5151
Fax Number
person
Provider Business Mailing Address Details
Address
1015 Michigan Ave
City
Logansport
State
Indiana
Zip
46947-1526
Phone Number
574-722-5151
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
28177692A (Indiana)
Definition
Definition to come...
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