1548680093 NPI number — TIFFANY DAWN WEST BRANDT PH.D.

Table of content: TIFFANY DAWN WEST BRANDT PH.D. (NPI 1548680093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548680093 NPI number — TIFFANY DAWN WEST BRANDT PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRANDT
Provider First Name:
TIFFANY
Provider Middle Name:
DAWN WEST
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEST
Provider Other First Name:
TIFFANY
Provider Other Middle Name:
DAWN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548680093
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8201 NORTHWOODS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68505-3092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-465-5600
Provider Business Mailing Address Fax Number:
402-327-6074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4020 HOHENSEE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68516-3927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-465-5600
Provider Business Practice Location Address Fax Number:
402-327-6074
Provider Enumeration Date:
04/23/2014

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: 103T00000X , with the licence number:  986 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com