Provider Demographics
NPI:1619576436
Name:TANNER, MEAGAN (DOULA)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:TANNER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14152 W SURREY DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-6640
Mailing Address - Country:US
Mailing Address - Phone:623-261-0625
Mailing Address - Fax:
Practice Address - Street 1:14152 W SURREY DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-6640
Practice Address - Country:US
Practice Address - Phone:623-261-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula