Provider Demographics
NPI:1215590153
Name:LAPAN, TIFFANIE (DMPNA, CRNA, SRNP)
Entity Type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:LAPAN
Suffix:
Gender:F
Credentials:DMPNA, CRNA, SRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 HILTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-9033
Mailing Address - Country:US
Mailing Address - Phone:808-381-8296
Mailing Address - Fax:
Practice Address - Street 1:312 9TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2929
Practice Address - Country:US
Practice Address - Phone:319-352-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAUNKNOWN367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered