Provider Demographics
NPI:1942841432
Name:APPLE, TIFFANY TARRIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:TARRIA
Last Name:APPLE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:TARRIA
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BSN, MSA
Mailing Address - Street 1:11509 TAGUS DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9641
Mailing Address - Country:US
Mailing Address - Phone:661-472-3577
Mailing Address - Fax:
Practice Address - Street 1:11509 TAGUS DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9641
Practice Address - Country:US
Practice Address - Phone:661-472-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-05
Last Update Date:2019-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA673790163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator