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General NPI Number Information
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NPI Number | 1982038642
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Entity Type | Individual
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Provider Name | KIMBERLEY A TANNER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 7380 ENGLE RD
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City | MIDDLEBURG HEIGHTS
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State | OH
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Zip | 44130-3429
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Country | US
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Telephone | 440-239-3438
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Fax |
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Provider Business Mailing Address
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Address Line | 3887 LEEWOOD RD
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City | STOW
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State | OH
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Zip | 44224-2435
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Country | US
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Telephone | 216-702-0910
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.350893-
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License Number State | OH
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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 | APRN.CNP.0040565
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | APRN.CNP.0040565
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License Number State | OH
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