TIFFANI PETERSEN (NPI# 1255968681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255968681 |
| Entity Type | Individual |
| Full Name | TIFFANI PETERSEN |
| Credential | RN |
| Practice Address |
1034 N 500 W Provo UT 84604-3380 |
| Mailing Address |
179 S 1125 W Springville UT 84663-5757 |
| Practice Telephone | 8013577376 |
| Mailing Telephone | 8017175561 |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-07-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
7453288-3102 | UT | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
7453288-8900 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1034 N 500 W |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780671453 | Marc Sune Robins | Family Medicine | 1034 N 500 W, Provo, UT 84604-3380 | 2005-09-28 |
| 1417562885 | Mckenzie Hamilton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-09-13 |
| 1235741042 | Kristi Kay Anderson | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-08-21 |
| 1477188811 | Jodi Benson | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-05 |
| 1649815879 | Jessica Ricaurte | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-11-12 |
| 1174167795 | Courtney Danielle Akina | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3337 | 2019-11-06 |
| 1396393609 | Camille Stanley | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-29 |
| 1386292076 | Rebecca Harris | Occupational Therapist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-27 |
| 1770139289 | Cameron Lee Tingey | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-12 |
| 1770138216 | Shawn Crnich | Occupational Therapist | 1034 N 500 W, Provo, UT 84604 | 2019-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700963295 | Michelle Marie Mcnew | Nurse Practitioner | 750 N 200 W Ste 300, Provo, UT 84601-1690 | 2006-11-01 |
| 1588217723 | Erin Ellsworth Falor | Nurse Practitioner | 395 W Bulldog Blvd Ste 601, Provo, UT 84604-3331 | 2019-07-17 |
| 1124584867 | Lisa O'donnal | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2019-02-19 |
| 1588150304 | Christopher Bickmore Parson | Nurse Practitioner | 395 W Bulldog Blvd, Provo, UT 84604-3311 | 2018-07-04 |
| 1518484005 | Chaz Derrick Colton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2017-08-24 |
| 1538698550 | Kelsie Balmforth | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2017-06-05 |
| 1609223726 | Younchan Lee | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601 | 2016-05-18 |
| 1972986057 | Steven Faux | Nurse Practitioner | 1157 N 300 W, Suite 303, Provo, UT 84604-6124 | 2015-07-07 |
| 1669814505 | Brandon Thatcher | Nurse Practitioner | 1750 N Wymount Terrace Dr, Provo, UT 84602-7600 | 2013-07-19 |
| 1598993040 | Erin Marie Haggerty | Nurse Practitioner | 619 N 500 W, Provo, UT 84601-1547 | 2009-06-23 |
| Find all providers in PROVO | ||||
Please comment or provide details below to improve the information on TIFFANI PETERSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.