TIFFANY HICKS GARDNER (NPI# 1457823056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457823056 |
| Entity Type | Individual |
| Full Name | TIFFANY HICKS GARDNER |
| Credential | APRN |
| Practice Address |
1155 Cedar Ct Carbondale IL 62901-5333 |
| Mailing Address |
Po Box 423 Carrier Mills IL 62917-0423 |
| Practice Telephone | 6184901045 |
| Mailing Telephone | 6184992307 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209017781 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790257392 | Tiffany Yvette Gardner | Nurse Practitioner | 301 Fm 757, Tyler, TX 75705-4503 | 2018-12-20 |
| 1992205637 | Tiffany Gardner | Registered Nurse | 2327 Londonderry Ln, Cordova, TN 38016-8413 | 2018-02-20 |
| 1588935654 | Tiffany Gardner | Occupational Therapist | 6950 Greenbriar Dr, Owasso, OK 74055-7388 | 2012-01-22 |
| 1558821702 | Tiffany Alexis Gardner | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave Ste B177, Aurora, CO 80045-2527 | 2019-03-22 |
| 1306240106 | Tiffany Marie Gardner | Nurse Practitioner | 1930 Bishop Ln Fl 12, Louisville, KY 40218 | 2014-10-22 |
| Street Address |
1155 CEDAR CT |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053492710 | Clifford Loren Coleman | Specialist | 1155 Cedar Ct, Carbondale, IL 62901-5333 | 2006-10-18 |
| 1821307976 | Clifford L Coleman & Associates Ltd | Specialist | 1155 Cedar Ct, Carbondale, IL 62901-5333 | 2010-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023375409 | Natasha Charlyn Shafer | Nurse Practitioner | 1340 Cedar Ct Ste 202, Carbondale, IL 62901 | 2012-04-23 |
| 1295923779 | Kellie J Lustenberger | Nurse Practitioner | 305 W. Jackson, Suite 100, New Horizons Obstetrics & Gynecology, Carbondale, IL 62901 | 2007-10-09 |
| 1649373770 | Valerie Jean Ting | Nurse Practitioner | 3839 Boskydell Rd, Carbondale, IL 62903-7622 | 2006-09-06 |
| 1568071132 | Cynthia Sue Davis | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-29 |
| 1306465919 | Michelle Corzine | Nurse Practitioner | 404 S Lewis Ln, Carbondale, IL 62901-3547 | 2020-04-14 |
| 1609388545 | Rina Elizabeth Caslow | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901 | 2017-11-01 |
| 1407366123 | Ariele N. Loiacono | Nurse Practitioner | 1100 W Diann Ln, Carbondale, IL 62901-5339 | 2017-10-08 |
| 1073030789 | Carrie Ann Lutman | Nurse Practitioner | 2250 N Illinois Ave, Carbondale, IL 62901-5612 | 2017-08-23 |
| 1699120055 | Jessica Serena Marie Belobraydic | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62902-9000 | 2016-05-04 |
| 1225499825 | Ashley Nicole Freeman | Nurse Practitioner | 305 W Jackson St, Ste 103, Carbondale, IL 62901 | 2016-03-10 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on TIFFANY HICKS GARDNER.
| 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.