Provider Demographics
NPI:1932102381
Name:ENGELKEN, TIFFANY NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NICOLE
Last Name:ENGELKEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:NICOLE
Other - Last Name:FELDKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1600 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-9739
Mailing Address - Country:US
Mailing Address - Phone:785-336-6181
Mailing Address - Fax:785-336-2578
Practice Address - Street 1:1600 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-9739
Practice Address - Country:US
Practice Address - Phone:785-336-6181
Practice Address - Fax:785-336-2578
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP98905Medicare UPIN
KSP98905Medicare UPIN