Provider Demographics
NPI:1962819920
Name:DEEM, TIFFANY BARR (CRNP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:BARR
Last Name:DEEM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:BARR
Other - Last Name:LARUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:13 ARMAND HAMMER BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5067
Mailing Address - Country:US
Mailing Address - Phone:610-327-7770
Mailing Address - Fax:610-705-5698
Practice Address - Street 1:1220 BROADCASTING RD STE 100
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3221
Practice Address - Country:US
Practice Address - Phone:610-207-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily