Provider Demographics
NPI:1720216278
Name:GARNER, L'ERIN LEIGH-ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:L'ERIN
Middle Name:LEIGH-ANNE
Last Name:GARNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:L'ERIN
Other - Middle Name:LEIGH-ANNE
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-0549
Mailing Address - Country:US
Mailing Address - Phone:260-569-9550
Mailing Address - Fax:260-569-9244
Practice Address - Street 1:3510 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953
Practice Address - Country:US
Practice Address - Phone:765-662-6594
Practice Address - Fax:765-662-6595
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003602A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200945250Medicaid
IN200945250Medicaid
IN160450XMedicare PIN
INM400074563Medicare PIN
IN296080PMedicare PIN
IN252690HMedicare PIN