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1790294007
CHRISTIAN DALE TANNER
SAINT JOSEPH, MO
NPI
1790294007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2017035200)
Enumeration Date
2017-09-29
Last Update Date
2017-09-29
Business Address
Mr. CHRISTIAN DALE TANNER FNP-C
5001 LAKE AVE
SAINT JOSEPH, MO 64504-1170
Phone number: 816-238-7788
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Mailing Address
Mr. CHRISTIAN DALE TANNER FNP-C
18400 SE HIGHWAY 371
DEARBORN, MO 64439-8161
Phone number: 816-210-6360
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