Provider Demographics
NPI:1770445041
Name:HERB, TANNER (BSN, RN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:TANNER
Middle Name:
Last Name:HERB
Suffix:
Gender:M
Credentials:BSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2904
Mailing Address - Country:US
Mailing Address - Phone:215-385-4717
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE 526
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3721
Practice Address - Country:US
Practice Address - Phone:610-697-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP034363363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health