Provider Demographics
NPI:1366988990
Name:ULERY TANNER, REBECCA E (CNM)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:ULERY TANNER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:ULERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:14633 DARBY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146-9192
Mailing Address - Country:US
Mailing Address - Phone:740-361-4804
Mailing Address - Fax:
Practice Address - Street 1:4439 STATE ROUTE 159
Practice Address - Street 2:SUITE 120
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019324367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife