Provider Demographics
NPI:1144657123
Name:CLARY, TANYA MAY (CNS)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:MAY
Last Name:CLARY
Suffix:
Gender:M
Credentials:CNS
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Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:317-963-0860
Mailing Address - Fax:317-963-1453
Practice Address - Street 1:11725 N. ILLINOIS ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3009
Practice Address - Country:US
Practice Address - Phone:317-688-2647
Practice Address - Fax:317-688-2921
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2014-11-12
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Provider Licenses
StateLicense IDTaxonomies
IN28169284A364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist