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General NPI Number Information
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NPI Number | 1699170019
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Entity Type | Individual
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Provider Name | KIMBERLY NICOLE VANN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2946 COVINGTON PIKE
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City | MEMPHIS
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State | TN
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Zip | 38128-6007
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Country | US
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Telephone | 901-382-9292
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Fax | 901-384-5696
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Provider Business Mailing Address
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Address Line | 1669 SHELBY OAKS DR N STE 106
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City | MEMPHIS
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State | TN
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Zip | 38134-7441
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Country | US
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Telephone | 901-382-9292
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Fax | 901-384-5696
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4046996
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19303
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11038990
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 0001336503
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0038831
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 0038831
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024193110
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License Number State | VA
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61673264
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | APRN11038990
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | AP61673264
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License Number State | WA
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704426280
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4704426280
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License Number State | MI
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Taxonomy #13
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 161088
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License Number State | TN
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Taxonomy #14
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4046996
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License Number State | KY
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Taxonomy #15
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 833204
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License Number State | NY
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