Provider Demographics
NPI:1164006698
Name:MORRIS, TIFFANY (BSN, RN, CDCES)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:BSN, RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 S CLIFTON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2958
Mailing Address - Country:US
Mailing Address - Phone:316-274-8414
Mailing Address - Fax:316-221-5696
Practice Address - Street 1:1515 S CLIFTON AVE STE 205
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2958
Practice Address - Country:US
Practice Address - Phone:316-274-8414
Practice Address - Fax:316-221-5696
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS32100265163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator