Provider Demographics
NPI:1295085165
Name:MORELAND, TIANA CORRINE (CNP)
Entity type:Individual
Prefix:MRS
First Name:TIANA
Middle Name:CORRINE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 DEEP WOODS CT
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45005
Mailing Address - Country:US
Mailing Address - Phone:937-901-8699
Mailing Address - Fax:
Practice Address - Street 1:1431 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1411
Practice Address - Country:US
Practice Address - Phone:937-348-7001
Practice Address - Fax:937-949-6113
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13793-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily