Provider Demographics
NPI:1346618733
Name:GUGLIELMELLI, TIFFANY MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:GUGLIELMELLI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 480
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3676
Mailing Address - Country:US
Mailing Address - Phone:703-248-0111
Mailing Address - Fax:703-248-0046
Practice Address - Street 1:1635 N GEORGE MASON DR STE 480
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3676
Practice Address - Country:US
Practice Address - Phone:703-248-0111
Practice Address - Fax:703-248-0046
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00011250395163W00000X
MDAC001605363LF0000X
VA0024183804363LF0000X
DCRN1014316163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily