| Ms Tara Lynn Favis, NP-C | |
|
77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 | |
| (916) 454-2345 | |
| Not Available |
| Full Name | Ms Tara Lynn Favis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 77 Cadillac Dr Ste 200, Sacramento, California |
| 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 | 95013467 (California) | 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 Lynn Favis, NP-C 1860 Howe Ave Ste 440, Sacramento, CA 95825-1098 Ph: (916) 569-8484 | Ms Tara Lynn Favis, NP-C 77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 Ph: (916) 454-2345 |
Alexia Pratt Monahan, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2279 45th St, Sacramento, CA 95817 Phone: 916-734-5959 |
Blanca E Avila, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2 Scripps Dr Ste 302, Sacramento, CA 95825 Phone: 714-472-7942 |
Sumon Johnson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2570 48th St, Sacramento, CA 95817 Phone: 916-734-2145 |
Elena Walterman, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2315 Stockton Blvd Ste 1507, Sacramento, CA 95817 Phone: 916-734-2387 |
Sharon Kay Mccoy, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2025 Morse Ave, Sacramento, CA 95825 Phone: 916-973-6935 |
Frances Eileen Briare, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6600 Bruceville Rd, Sacramento, CA 95823 Phone: 916-688-2000 |
Ms. Patricia Lynne Kang, GNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6600 Bruceville Rd, Eldercare Adult Medicine F, Sacramento, CA 95823 Phone: 916-688-6862 Fax: 916-973-6682 |