Provider Demographics
NPI:1841867389
Name:TOBE, TIFFANI J (CNS)
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:J
Last Name:TOBE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 MCCORD WAY APT 1222
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1180
Mailing Address - Country:US
Mailing Address - Phone:317-525-1033
Mailing Address - Fax:
Practice Address - Street 1:1801 MCCORD WAY APT 1222
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1180
Practice Address - Country:US
Practice Address - Phone:317-525-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011144A364SP0200X
TX1117645364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300050917Medicaid