Individual
KIMBERLY TANNER FAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP, APRN
Contact information
Practice address
1204 MEDICAL PARK DR, OXFORD, MS 38655-5326
(662) 236-5717
(662) 234-4016
Mailing address
8110 N BROTHER BLVD STE 200, BARTLETT, TN 38133-2760
(901) 255-5221
(901) 373-4511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R854373
MS
363LF0000X
Family Nurse Practitioner
854373
MS
363LW0102X
Women's Health Nurse Practitioner
Primary
854373
MS
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
R854373
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3459830
—
MS
Enumeration date
06/02/2008
Last updated
03/03/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us