Provider Demographics
NPI:1235700907
Name:TIFFANY, MEGAN (RN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:TIFFANY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5352
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-853-0222
Practice Address - Fax:540-981-7855
Is Sole Proprietor?:No
Enumeration Date:2021-07-05
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024187439367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered