Provider Demographics
NPI:1629574561
Name:TAMASFI, TIFFANY EVE (DNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:EVE
Last Name:TAMASFI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:EVE
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:332 SAINT GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2437
Mailing Address - Country:US
Mailing Address - Phone:904-377-0265
Mailing Address - Fax:
Practice Address - Street 1:220 S PARK AVE FL 2
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3602
Practice Address - Country:US
Practice Address - Phone:618-988-6240
Practice Address - Fax:618-351-4814
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017657363LF0000X
FLARNP9360950363LF0000X
IL209017657363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily