Provider Demographics
NPI:1477843472
Name:MCMANIS, TIFFANY LYN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LYN
Last Name:MCMANIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:L
Other - Last Name:WULLSCHLEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1700 SW COLLEGE AVE
Mailing Address - Street 2:MORGAN HALL ROOM 170
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66621-0001
Mailing Address - Country:US
Mailing Address - Phone:785-670-1470
Mailing Address - Fax:785-670-1029
Practice Address - Street 1:1700 SW COLLEGE AVE
Practice Address - Street 2:MORGAN HALL ROOM 170
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66621-0001
Practice Address - Country:US
Practice Address - Phone:785-670-1470
Practice Address - Fax:785-670-1029
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011008571363LA2200X, 363LF0000X
KS53-75333-071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health