Provider Demographics
NPI:1184984445
Name:PLUNK, TIFFANY QUINN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:QUINN
Last Name:PLUNK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 HOSPITAL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1948
Mailing Address - Country:US
Mailing Address - Phone:276-666-0452
Mailing Address - Fax:276-666-0363
Practice Address - Street 1:319 HOSPITAL DR STE 202
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1948
Practice Address - Country:US
Practice Address - Phone:276-666-0452
Practice Address - Fax:276-666-0363
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily