Provider Demographics
NPI:1235916495
Name:KOCHAN, TIFFINY ELESE (APRN)
Entity Type:Individual
Prefix:
First Name:TIFFINY
Middle Name:ELESE
Last Name:KOCHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TIFFINY
Other - Middle Name:ELESE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2858 SW VILLA WEST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5474
Mailing Address - Country:US
Mailing Address - Phone:888-901-6621
Mailing Address - Fax:
Practice Address - Street 1:2858 SW VILLA WEST DR STE 100
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5474
Practice Address - Country:US
Practice Address - Phone:188-890-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82507-042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily