Provider Demographics
NPI:1568926145
Name:PIGNATELLO, TIFFANY FITZ (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:FITZ
Last Name:PIGNATELLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12071 CADYS COVE DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:VA
Mailing Address - Zip Code:23069-1626
Mailing Address - Country:US
Mailing Address - Phone:804-641-4613
Mailing Address - Fax:
Practice Address - Street 1:1200 E MARSHALL ST FL 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5049
Practice Address - Country:US
Practice Address - Phone:804-828-4396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily