Provider Demographics
NPI:1073399440
Name:MCDOW, TIFFANY LANEE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LANEE
Last Name:MCDOW
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E LAMAR BLVD APT 362
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-1148
Mailing Address - Country:US
Mailing Address - Phone:469-826-9214
Mailing Address - Fax:
Practice Address - Street 1:923 PENNSYLVANIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2254
Practice Address - Country:US
Practice Address - Phone:817-920-0484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1102137363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care