Provider Demographics
NPI:1629574561
Name:TAMASFI, TIFFANY EVE (DNP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:EVE
Last Name:TAMASFI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:EVE
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:332 SAINT GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2437
Mailing Address - Country:US
Mailing Address - Phone:904-377-0265
Mailing Address - Fax:
Practice Address - Street 1:4025 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:773-388-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9360950363LF0000X
IL209.017657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily