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Kimberly Tanner Fava, WHCNP,APRN
Nurse Practitioner in Clarksdale, Mississippi
NPI 1215195631

Kimberly Tanner Fava is a Nurse Practitioner based in Clarksdale, MS. Kimberly Tanner Fava practices in Clarksdale, MS and has the professional credentials of WHCNP,APRN. The NPI Number for Kimberly Tanner Fava is 1215195631 and holds a License No. R854373 (Mississippi).

The current practice location address for Kimberly Tanner Fava is 2000 N State St, Clarksdale, MS and can be reached out via phone at 662-627-7361 and via fax at 662-627-1158. You can also correspond with Kimberly Tanner Fava through the mailing address at 2000 N STATE ST, CLARKSDALE, MS - 38614-6100 (mailing address contact number: 662-627-7361).

Location: 2000 N State St, Clarksdale, MS, 38614-6100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215195631
Provider Name
Kimberly Tanner Fava
Credential
WHCNP,APRN
Provider Entity Type
Individual
Gender
Female
Address
2000 N State St, Clarksdale, MS, 38614-6100
Phone Number
662-627-7361
Fax Number
662-627-1158
Provider Enumeration Date
06/02/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3459830 05 MS
institution
Provider Business Practice Location Address Details
Address
2000 N State St
City
Clarksdale
State
Mississippi
Zip
38614-6100
Phone Number
662-627-7361
Fax Number
662-627-1158
person
Provider Business Mailing Address Details
Address
2000 N State St
City
Clarksdale
State
Mississippi
Zip
38614-6100
Phone Number
662-627-7361
Fax Number
662-627-1158
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
R854373 (Mississippi)
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 certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Obstetrics & Gynecology
Taxonomy
363LX0001X
License No.
R854373 (Mississippi)
Definition
Definition to come...
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