Provider Demographics
NPI:1992022685
Name:WHITMILL, TIFFANY D (CST/CFA)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:D
Last Name:WHITMILL
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 ROLLING HILLS PL
Mailing Address - Street 2:APT. 1104
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1800
Mailing Address - Country:US
Mailing Address - Phone:469-463-4692
Mailing Address - Fax:
Practice Address - Street 1:485 ROLLING HILLS PL
Practice Address - Street 2:1104
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1800
Practice Address - Country:US
Practice Address - Phone:469-463-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant