Kimberly Tanner Fava in Clarksdale - Nurse Practitioner
Kimberly Tanner Fava - NPI 1215195631
Kimberly Tanner Fava is a Nurse Practitioner in Clarksdale, Mississippi. Kimberly Tanner Fava practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Kimberly Tanner Fava is 1215195631. The last update date is 2023-01-11.
Kimberly Tanner Fava's current location address is 2000 N State St, Clarksdale, Mississippi. You can contact this provider via phone number 6626277361 and fax number 6626271158. The mailing address for Kimberly Tanner Fava is 2000 N State St, Clarksdale, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly Tanner Fava |
|---|---|
| Address | 2000 N State St, Clarksdale, Mississippi |
| Phone Number | 6626277361 |
| Fax Number | 6626271158 |
| Sole Proprietor | N |
| Credentials | WHCNP, APR |
NPI Number Detail
| NPI Number | 1215195631 |
|---|---|
| Provider Enumeration Date | 2008-06-02 |
| Last Updated Date | 2023-01-11 |
Provider Mailing Address Detail
| Address | 2000 N State St |
|---|---|
| City | Clarksdale |
| State | Mississippi (MS) |
| Post Code | 386146100 |
| Phone Number | 6626277361 |
| Fax Number | 6626271158 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | R854373 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3459830 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kimberly Tanner Fava by the Centers for Medicare & Medicaid Services?
The Kimberly Tanner Fava has been assigned the NPI (National Provider Identifier) 1215195631 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Kimberly Tanner Fava?
The Kimberly Tanner Fava is situated at 2000 N State St, in the city of Clarksdale, state of MS, with the zip code 386146100.
What is Kimberly Tanner Fava's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kimberly Tanner Fava is Nurse Practitioner, and the taxonomy classification code that categorizes this area of expertise is 363L00000X.
When did the Kimberly Tanner Fava receive its 1215195631?
The Kimberly Tanner Fava was issued its 1215195631 on 2008-06-02, which is the date when the organization was assigned this unique identifier.
When was the information regarding Kimberly Tanner Fava most recently updated?
The details pertaining to the Kimberly Tanner Fava, including its address, specialty, and other relevant information, were last refreshed on 2023-01-11.
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