Provider Demographics
NPI:1710754346
Name:CARTEE, TIFFANY ANNE
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANNE
Last Name:CARTEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:KANAWHA
Mailing Address - State:IA
Mailing Address - Zip Code:50447-7728
Mailing Address - Country:US
Mailing Address - Phone:641-203-0502
Mailing Address - Fax:
Practice Address - Street 1:315 E 3RD ST
Practice Address - Street 2:
Practice Address - City:KANAWHA
Practice Address - State:IA
Practice Address - Zip Code:50447-7728
Practice Address - Country:US
Practice Address - Phone:641-203-0502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA124843163W00000X
IA752YY9918172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No163W00000XNursing Service ProvidersRegistered Nurse