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

Tanner C Kimble, CST/CSFA

Individual provider Surgical Assistant · NPI 1043988116

Tanner C Kimble, CST/CSFA is a Surgical Assistant in Vicksburg, Mississippi. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone: (601) 883-5000
Show map & directions

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

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 188016

Record details

NPI number1043988116
Entity typeIndividual (Type 1)
GenderMale
Credentials CST/CSFA
Sole proprietorYes
NPI enumeratedSeptember 2, 2021
Last updated in NPPESFebruary 15, 2022
Certification dateFebruary 15, 2022
Mailing address406 Lacasa Loop, Twin Falls, ID 83301-5663

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