Provider Demographics
NPI:1578326278
Name:FELKER, TIFFANY ANN
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:FELKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 JOHNSON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-1624
Mailing Address - Country:US
Mailing Address - Phone:270-899-0136
Mailing Address - Fax:
Practice Address - Street 1:507 JOHNSON ST APT 3
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-1624
Practice Address - Country:US
Practice Address - Phone:270-899-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171400000XOther Service ProvidersHealth & Wellness Coach