Ms Tara Favis, NP-C | |
7869 Villa Rica Hwy, Dallas, GA 30157-8638 | |
(770) 459-8449 | |
Not Available |
Full Name | Ms Tara Favis |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 7869 Villa Rica Hwy, Dallas, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013279132 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | RN195879 (Georgia) | Primary |
Entity Name | Lifetime Family Medicine,llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053509216 PECOS PAC ID: 3577646736 Enrollment ID: O20080211000608 |
Entity Name | Wellstar Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
Mailing Address | Practice Location Address |
---|---|
Ms Tara Favis, NP-C 7869 Villa Rica Hwy, Dallas, GA 30157-8638 Ph: (770) 459-8449 | Ms Tara Favis, NP-C 7869 Villa Rica Hwy, Dallas, GA 30157-8638 Ph: (770) 459-8449 |
Kimberly Williams Naab, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 455 Nathan Dean Blvd, Dallas, GA 30132 Phone: 770-505-3837 | |
Karen F Frazier, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 495 Charles Hardy Pkwy, Dallas, GA 30157 Phone: 770-231-4783 | |
Yolonda Michelle Rawls, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 149 Parkmont Court, Dallas, GA 30132 Phone: 770-866-1777 | |
Amy Evans, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 105 Village Walk Ste 280, Dallas, GA 30132 Phone: 770-800-6780 | |
Aline Ange Well, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 455 Nathan Dean Blvd, Dallas, GA 30132 Phone: 770-505-3837 | |
Joni Baumann, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 600 W Memorial Dr, Dallas, GA 30132 Phone: 770-445-4411 |