Tanner, Dawn Clarisse

Tanner, Dawn Clarisse is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61603-4307. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Tanner, Dawn Clarisse can be contacted via phone (309) 672-5522.

Contact Information

Primary practice address
221 Ne Glen Oak Ave Peoria IL 61603-4307
Phone: (309) 672-5522
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-002863 Illinois

Profile Details

NPI number 1295898591
LBN Legal business name Tanner, Dawn Clarisse
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Jul 13th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295898591 NPPES
Illinois Other P00841537 RRMCARE THRU CES

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