Provider Demographics
NPI:1316186745
Name:THOMAS, TIFFINIE DESHAE ARZELL (RN)
Entity Type:Individual
Prefix:MISS
First Name:TIFFINIE
Middle Name:DESHAE ARZELL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93709-0548
Mailing Address - Country:US
Mailing Address - Phone:559-275-5468
Mailing Address - Fax:559-275-8585
Practice Address - Street 1:3568 W CORTLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-4731
Practice Address - Country:US
Practice Address - Phone:559-275-5462
Practice Address - Fax:559-275-8585
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA722781163W00000X, 163WC0400X, 163WC1500X, 163WG0000X, 163WM0102X, 163WN0003X, 163WP0200X, 163WP1700X, 163WW0101X, 163WX0002X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient