Provider Demographics
NPI:1356863039
Name:KUEHN, TIFFANY MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:KUEHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 N BERMUDA
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6116
Mailing Address - Country:US
Mailing Address - Phone:480-255-1650
Mailing Address - Fax:
Practice Address - Street 1:2152 S VINEYARD STE 138
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6882
Practice Address - Country:US
Practice Address - Phone:480-539-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN195117163WH0200X, 163WI0500X, 163WM0705X, 163WM1400X, 163WW0000X, 163WW0101X, 163WX0003X, 163W00000X
AZMT-02767225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist