Provider Demographics
NPI:1578118436
Name:BURCH, TIFFANY MARIE (CMA, BCN-T)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:BURCH
Suffix:
Gender:F
Credentials:CMA, BCN-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 W 94TH TER STE 200
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2521
Mailing Address - Country:US
Mailing Address - Phone:913-383-8100
Mailing Address - Fax:
Practice Address - Street 1:5200 W 94TH TER STE 200
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2521
Practice Address - Country:US
Practice Address - Phone:913-383-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG