1477843472 NPI number — MRS. TIFFANY LYN MCMANIS ARNP

Table of content: MRS. TIFFANY LYN MCMANIS ARNP (NPI 1477843472)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477843472 NPI number — MRS. TIFFANY LYN MCMANIS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMANIS
Provider First Name:
TIFFANY
Provider Middle Name:
LYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WULLSCHLEGER
Provider Other First Name:
TIFFANY
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477843472
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 SW COLLEGE AVE
Provider Second Line Business Mailing Address:
MORGAN HALL ROOM 170
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66621-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-670-1470
Provider Business Mailing Address Fax Number:
785-670-1029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 SW COLLEGE AVE
Provider Second Line Business Practice Location Address:
MORGAN HALL ROOM 170
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66621-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-670-1470
Provider Business Practice Location Address Fax Number:
785-670-1029
Provider Enumeration Date:
04/11/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  2011008571 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 2011008571 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 53-75333-071 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)