Provider Demographics
NPI:1619570769
Name:YOWELL, TIFFANY K (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:K
Last Name:YOWELL
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 1:5221 MEADOW SWEET LN
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-3601
Mailing Address - Country:US
Mailing Address - Phone:913-687-3237
Mailing Address - Fax:
Practice Address - Street 1:225 BLUFF ST
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-9703
Practice Address - Country:US
Practice Address - Phone:402-878-2231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
KS5379705363LF0000X
MO2021032480363LF0000X
NE113847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171000000XOther Service ProvidersMilitary Health Care Provider