Provider Demographics
NPI:1184316762
Name:HAFER, TIFFANY MARIE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:HAFER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 SE 99TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-6369
Mailing Address - Country:US
Mailing Address - Phone:352-233-9998
Mailing Address - Fax:
Practice Address - Street 1:3875 WEDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9301
Practice Address - Country:US
Practice Address - Phone:352-674-4800
Practice Address - Fax:352-674-4801
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily