Provider Demographics
NPI:1871093385
Name:WARREN, TIFFANY LEIGH (APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LEIGH
Last Name:WARREN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9390 E CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2565
Mailing Address - Country:US
Mailing Address - Phone:316-733-4747
Mailing Address - Fax:316-733-5253
Practice Address - Street 1:9390 E CENTRAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2565
Practice Address - Country:US
Practice Address - Phone:316-252-1237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78047-072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily