Provider Demographics
NPI:1588234777
Name:HOWARD, TIFFANEY (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANEY
Middle Name:
Last Name:HOWARD
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 1:1150 HANLEY INDUSTRIAL CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1910
Mailing Address - Country:US
Mailing Address - Phone:314-401-2459
Mailing Address - Fax:
Practice Address - Street 1:1150 HANLEY INDUSTRIAL CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-1910
Practice Address - Country:US
Practice Address - Phone:314-401-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010021100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse