JACKIE R TANNER (NPI# 1609229343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609229343 |
| Entity Type | Individual |
| Full Name | JACKIE R TANNER |
| Credential | ARNP |
| Practice Address |
6850 New Tampa Hwy Lakeland FL 33815-3168 |
| Mailing Address |
1558 Doves View Cir Auburndale FL 33823-2753 |
| Practice Telephone | 8635837100 |
| Mailing Telephone | 8632067969 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2019-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APRN9208911 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6850 NEW TAMPA HWY |
| City | LAKELAND |
| State | FL |
| Zip Code | 33815-3168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174162093 | Deborah Beall Boynton | Counselor | 219 Hillcrest St, Lakeland, FL 33815 | 2019-12-23 |
| 1992247373 | Lizvel Rosario | Counselor | 220 Lake Wire Dr., Lakeland, FL 33815 | 2016-11-16 |
| 1235554783 | Florida Baptist Children's Homes | Community Based Residential Treatment Facility, Mental Illness | 1015 Sikes Blvd., Lakeland, FL 33815 | 2014-02-20 |
| 1902229255 | Christina Miller | Nurse Practitioner | 6850 New Tampa Hwy Ste 600, Lakeland, FL 33815 | 2014-01-22 |
| 1902111099 | Jeanene Nicole Robinson-kyles | Psychologist | 505 Martin L. King Jr. Ave, Suite 1, Lakeland, FL 33815 | 2010-08-12 |
| 1235287095 | Wendell Owen Blake | Family Medicine | 505 Martin Luther King Ave, Suite 2, Lakeland, FL 33815 | 2007-01-08 |
| 1104983899 | Lake Wire Pharmacy Inc | Pharmacist | 505 Martin Luther King Jr Ave, Suite 3, Lakeland, FL 33815 | 2007-01-02 |
| 1427038637 | Rotech Oxygen and Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 5315 Great Oak Drive, Lakeland, FL 33815 | 2006-01-23 |
| 1598205841 | Daphne Toussaint | Dentist | 607 S Missouri Ave, Lakeland, FL 33815 | 2017-03-06 |
| 1083936058 | Blake and Franklin Md Pa | General Practice | 505 Martin Luther King Jr Ave, Ste 2, Lakeland, FL 33815 | 2010-02-18 |
| Find all providers in zip 33815 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770910341 | Rose M Owens | Nurse Practitioner | 1317 Hammock Shade Dr, Lakeland, FL 33809-2315 | 2013-09-27 |
| 1992284103 | Kristin Marie Johnson | Nurse Practitioner | 4315 Highland Park Blvd, Suite A, Lakeland, FL 33813 | 2018-08-08 |
| 1235639543 | Tonya Michell Leon | Nurse Practitioner | 4315 Highland Park Blvd, Lakeland, FL 33813-1639 | 2018-02-14 |
| 1508310145 | Natalie Dalton | Nurse Practitioner | 1325 Lakeland Hills Blvd, Lakeland, FL 33805-4544 | 2016-08-11 |
| 1518410315 | Paige Webb | Nurse Practitioner | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2016-07-27 |
| 1619227022 | Laura L Lewis | Nurse Practitioner | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2012-09-12 |
| 1649403569 | Marie E Parkman | Nurse Practitioner | 1417 Lakeland Hills Blvd, Ste 204, Lakeland, FL 33805-3200 | 2009-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629902 | Tara-kaye Clunis | Nurse Practitioner | 832 Nw 130th Ave, Pembroke Pines, FL 33028-3135 | 2020-11-06 |
| 1184225112 | Dante Strong | Nurse Practitioner | 208 Afton Sq Unit 301, Altamonte Springs, FL 32714-3841 | 2020-11-05 |
| 1730780354 | Mary Catherine Grissom | Nurse Practitioner | 2093 Appalachee Cir, Tavares, FL 32778-2001 | 2020-11-02 |
| 1942800974 | Justo J Ruiz | Nurse Practitioner | 11740 Sw 26th Ter, Miami, FL 33175-2451 | 2020-10-28 |
| 1891395208 | Jordyn Lee Platt | Nurse Practitioner | 1820 Coyote Pl, Brandon, FL 33511-1741 | 2020-10-27 |
| 1669071668 | Karine Erica Cameron | Nurse Practitioner | 12028 Sw 12th St, Pembroke Pines, FL 33025-3740 | 2020-10-21 |
| 1306443916 | Simmy Regin Varghese | Nurse Practitioner | 1613 Hammock Grove Ln, Jacksonville, FL 32225-5575 | 2020-10-06 |
| 1891302469 | Shannon Bre Anna Watkins | Nurse Practitioner | 2937 Quantum Lakes Dr, Boynton Beach, FL 33426-8303 | 2020-09-28 |
| 1114534856 | Cristina Sandu | Nurse Practitioner | 19327 Elston Way, Estero, FL 33928-6489 | 2020-09-27 |
| 1215543590 | Kam Lieng Lady | Nurse Practitioner | 12031 Nw 2nd Dr, Coral Springs, FL 33071-8012 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.