Provider Demographics
NPI:1750865564
Name:COHEE, TIFFANY LYNN
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNN
Last Name:COHEE
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 1:15802 N PARKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7466
Mailing Address - Country:US
Mailing Address - Phone:623-876-7923
Mailing Address - Fax:
Practice Address - Street 1:12950 W VARNEY RD
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-3184
Practice Address - Country:US
Practice Address - Phone:623-876-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN193452163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool