Provider Demographics
NPI:1114161031
Name:MEYERS, TIFFANY L (RN, FNP-C, CHFN)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:L
Last Name:MEYERS
Suffix:
Gender:F
Credentials:RN, FNP-C, CHFN
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:L
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL ROAD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5939
Mailing Address - Country:US
Mailing Address - Phone:816-931-1883
Mailing Address - Fax:816-756-3645
Practice Address - Street 1:4330 WORNALL ROAD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004025452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01131638Medicare PIN
MOMA2491064Medicare PIN
KSKA2004063Medicare PIN
MOMA2492064Medicare PIN
KSKA1724063Medicare PIN