Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen Fava, ACNP-BC

Individual provider Registered Nurse · NPI 1053682765

Kathleen Fava, ACNP-BC is a Nurse Practitioner in Providence, Rhode Island. Qualified in 2011, 15 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
15
Licensed in
RI
In the registry since
2012
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

593 Eddy Street Jane Brown 2 S
Providence, RI 02903-4923
Phone: (401) 444-5943
Fax: (401) 444-4216
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 593 Eddy St, Providence, RI 02903-4923 — (401) 444-5943

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence NPP37680 (RI)
Registered Nurse Taxonomy 163W00000X · Licence RN34380 (RI)

Record details

NPI number1053682765
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP-BC
Sole proprietorNo
NPI enumeratedJanuary 26, 2012
Last updated in NPPESDecember 5, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Providence