Provider Demographics
NPI:1679116610
Name:MCMAKIN, TIFFINEY (NP)
Entity Type:Individual
Prefix:
First Name:TIFFINEY
Middle Name:
Last Name:MCMAKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SAUNDERS AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-7522
Mailing Address - Country:US
Mailing Address - Phone:903-579-9800
Mailing Address - Fax:
Practice Address - Street 1:501 SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7522
Practice Address - Country:US
Practice Address - Phone:903-579-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily