Provider Demographics
NPI:1396546024
Name:SIMON, TIFFANY (RN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ROCK BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-4293
Mailing Address - Country:US
Mailing Address - Phone:402-660-3416
Mailing Address - Fax:
Practice Address - Street 1:1524 ROCK BLUFF RD
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-4293
Practice Address - Country:US
Practice Address - Phone:402-660-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care