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

Stacy Marie Tavenner

Individual provider Nurse Practitioner · NPI 1710535091

Stacy Marie Tavenner is a Nurse Practitioner in Henrico, Virginia. Works from 2 locations. Licensed in Florida, Georgia and Virginia.

Licensed in
FL, GA, VA
In the registry since
2019
Specialties on file
4

Practice location Address checks out

3001 Hungary Spring Rd Ste C
Henrico, VA 23228-2428
Phone: (317) 418-5138
Show map & directions

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

Additional practice locations (1)

  • 400 N Mount Zion Rd, Lebanon, IN 46052-9497 — (765) 335-0123

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN212253 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence 24185330 (VA)
Nurse Practitioner Taxonomy 363L00000X · Licence 11021325 (FL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence RN212253 (GA)

Record details

NPI number1710535091
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 29, 2019
Last updated in NPPESNovember 15, 2022
Certification dateNovember 15, 2022
Mailing address4830 Anvil Ct, Jefferson, GA 30549-8858

Other providers in Henrico