Provider Demographics
NPI:1609115708
Name:CUTBIRTH, TIFFANY RUTH (ANP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:RUTH
Last Name:CUTBIRTH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22698 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5700
Mailing Address - Country:US
Mailing Address - Phone:281-348-4050
Mailing Address - Fax:
Practice Address - Street 1:22698 PROFESSIONAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5700
Practice Address - Country:US
Practice Address - Phone:281-348-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX622548363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health