Individual ProviderDeborah S. TannehillNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128(260) 432-2297(260) 479-3514PECOS EnrollmentBased on the most recent information from CMS, provider Deborah S. Tannehill does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437306990Provider TypeIndividualFull NameTannehill, Deborah S.CredentialNPGenderFemaleSole ProprietorNoEnumeration Date8/26/2008Last Updated9/30/2020Contact InformationPractice LocationPractice Address7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128Phone(260) 432-2297Fax(260) 969-7266Mailing LocationMailing Address6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934Phone(260) 479-3514Fax(260) 479-3520Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71002774AIndianaProvider IdentifiersIDDescriptionIssuerID200922020DescriptionMedicaidIssuerUnlistedIndianaID000000697842DescriptionOtherIssuerANTHEMIndiana