Provider Demographics
NPI:1184143703
Name:TANNER, ANNA KATHERINE (MSW)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:KATHERINE
Last Name:TANNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATTIE
Other - Middle Name:
Other - Last Name:TANNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2441 COUNTY ROAD 501
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-9677
Mailing Address - Country:US
Mailing Address - Phone:662-837-4258
Mailing Address - Fax:
Practice Address - Street 1:2441 COUNTY ROAD 501
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-9677
Practice Address - Country:US
Practice Address - Phone:662-837-4258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health