Kimberley Brooke Tanner (NPI# 1023537073, PAC ID# 1658612049) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1023537073 |
| PAC ID by PECOS | 1658612049 |
| Professional Enrollment ID | I20190412000024 |
| Full Name | Kimberley Brooke Tanner |
| Organization Legal Name | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Address |
2506 Danville Rd Sw Suite 204b Decatur AL 35603-4234 |
| Phone Number | 2566864044 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3476735648 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010085 | DECATUR MORGAN HOSPITAL - DECATUR CAMPUS |
| 010131 | CRESTWOOD MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2506 Danville Rd Sw, Suite 204b, Decatur, AL 35603-4234 | 2566864044 | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Organization Legal Name | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mylena Morton | Internal Medicine | Crestwood Physician Services, LLC | 8121 Madison Blvd, Suite 101a, Madison, AL 35758-2082 |
| Carisa F Sparks | Nurse Practitioner | Crestwood Physician Services, LLC | 11365 Hwy 231 431 N, Meridianville, AL 35759-2145 |
| David R Mayer | Family Medicine | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Charles D. Coffey | Family Medicine | Crestwood Physician Services, LLC | 12100 County Line Rd, Suite A2, Madison, AL 35756-2006 |
| Bhavna Sharma | Family Medicine | Crestwood Physician Services, LLC | 102 Essex Ct, Suite C, Madison, AL 35758-3161 |
| Jenny C Chapman | Family Medicine | Crestwood Physician Services, LLC | 10300 Bailey Cove Rd Se, Suite 13, Huntsville, AL 35803-2635 |
| Amber J Whitfield | Family Medicine | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Valerie L Wright | Family Medicine | Crestwood Physician Services, LLC | 1650 Slaughter Rd, Suite A, Madison, AL 35758-8610 |
| Mary E Barry | Nurse Practitioner | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Yari Campbell | Family Medicine | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Street Address |
2506 DANVILLE RD SW SUITE 204B |
| City | DECATUR |
| State | AL |
| Zip | 35603-4234 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| George W Manifold | Obstetrics/gynecology | Crestwood Physician Services, LLC | 2506 Danville Rd Sw, Suite 204, Decatur, AL 35603-4232 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David A Francis | Family Medicine | 2828 Hwy 31 S, Suite 115, Decatur, AL 35603 | |
| John R Haney | Psychologist, Clinical | 1615 Kathy Sw Lane, Decatur, AL 35603-1026 | |
| Tina Jones-davis | Clinical Social Worker | Integrated Behavioral Health, Inc | 1615 Kathy Ln Sw, Decatur, AL 35603-1026 |
| Amber Dallman | Clinical Social Worker | Integrated Behavioral Health, Inc | 1615 Kathy Ln Sw, Decatur, AL 35603-1026 |
| Yelena V Chistyakova | Psychiatry | Integrated Behavioral Health, Inc | 1615 Kathy Ln Sw, Decatur, AL 35603-1026 |
| Bryant K Mahaffey | Psychiatry | Integrated Behavioral Health, Inc | 1615 Kathy Ln Sw, Decatur, AL 35603-1026 |
| Michael Douglas Dick | Family Practice | 2828 Hwy 31 S, Decatur, AL 35603-1337 | |
| Julie Grace Knop | Nurse Practitioner | American Family Care Inc | 2604 Hwy 31 S, Decatur, AL 35603-1506 |
| Landon G Dutton | Nurse Practitioner | American Family Care Inc | 2604 Hwy 31 S, Decatur, AL 35603-1506 |
| Daniel Nailor | Nurse Practitioner | American Family Care Inc | 2604 Hwy 31 S, Decatur, AL 35603-1506 |
| Find all physicians in zip 35603 | |||
| City | DECATUR |
| Zip Code | 35603 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DECATUR + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kimberley Brooke Tanner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.