Provider Demographics
NPI:1992233456
Name:WHITT, TANA ANN (APRN CNP)
Entity type:Individual
Prefix:
First Name:TANA
Middle Name:ANN
Last Name:WHITT
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:TANA
Other - Middle Name:ANN
Other - Last Name:HENLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3593 MEDINA RD STE 181
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8182
Mailing Address - Country:US
Mailing Address - Phone:330-536-3746
Mailing Address - Fax:888-204-5174
Practice Address - Street 1:3593 MEDINA RD STE 181
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8182
Practice Address - Country:US
Practice Address - Phone:330-536-3746
Practice Address - Fax:888-204-5174
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH399935163W00000X
OHAPRNCNP021116364SP0808X
OHAPRN.CNP.021116363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health