Provider Demographics
NPI:1144597402
Name:PRICE, TIPHANY (RN, BSN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TIPHANY
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN, BSN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:1180 SETON PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6178
Practice Address - Country:US
Practice Address - Phone:512-504-0860
Practice Address - Fax:512-504-0861
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731753363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX294385402Medicaid
TX294385401Medicaid
TX8837NLOtherBCBS
TX868N24OtherBCBS
TX294385403Medicaid
TX868N24OtherBCBS
TX294385403Medicaid
TXTXB147773Medicare PIN