Provider Demographics
NPI:1225350101
Name:BEHNKE, TIFFANY N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:N
Last Name:BEHNKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 CUTHBERTSON RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8111
Mailing Address - Country:US
Mailing Address - Phone:704-243-0738
Mailing Address - Fax:704-243-0857
Practice Address - Street 1:2531 CUTHBERTSON RD
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-8111
Practice Address - Country:US
Practice Address - Phone:704-243-0738
Practice Address - Fax:704-243-0857
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15586183500000X
SC10708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist