Provider Demographics
NPI:1295085165
Name:MORELAND, TIANA CORRINE (CNP)
Entity type:Individual
Prefix:MRS
First Name:TIANA
Middle Name:CORRINE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 DEEP WOODS CT
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45005
Mailing Address - Country:US
Mailing Address - Phone:937-901-8699
Mailing Address - Fax:
Practice Address - Street 1:9050 CENTRE POINTE DR
Practice Address - Street 2:SUITE # 400
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4874
Practice Address - Country:US
Practice Address - Phone:937-901-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13793-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily