TIFFANY BOWEN (NPI# 1750823795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750823795 |
| Entity Type | Individual |
| Full Name | TIFFANY BOWEN |
| Other Name | TIFFANY EFANTIS |
| Credential | NP |
| Practice Address |
508 Legacy Plz W La Porte IN 46350-5254 |
| Mailing Address |
211 N Eddy St South Bend IN 46617-2808 |
| Practice Telephone | 2195756244 |
| Practice Fax Number | 2193800757 |
| Mailing Telephone | 5742391433 |
| Mailing Fax Number | 5742391438 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71006816A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28199198A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 N Eddy St, South Bend, IN 466172808 | (574) 239-1433 | 5742391438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457844813 | Tiffany Jekara Bowen | Case Manager/Care Coordinator | 5640 Oakwood St, Spencer, OK 73084-8800 | 2018-06-11 |
| 1073533782 | Tiffany Allison Bowen | Nurse Practitioner | 321 E Fifteenth St, Yazoo City, MS 39194-2631 | 2006-07-19 |
| Street Address |
508 LEGACY PLZ W |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-5254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710594767 | Brooklynn Smock | Nurse Practitioner | 309 W Johnson Rd, La Porte, IN 46350-1982 | 2020-09-24 |
| 1518575182 | Joanne Lacoste | Nurse Practitioner | 931 Myrtle Creek Dr, La Porte, TX 77571-2767 | 2020-07-20 |
| 1922634542 | Raymond Joseph Keener | Nurse Practitioner | 711 W 250 S, La Porte, IN 46350-8108 | 2020-03-15 |
| 1174050603 | Agnes U Ololo | Nurse Practitioner | 3802 Stuart Dr, La Porte, TX 77571-3942 | 2017-05-15 |
| 1407159155 | Jocelyn Leigh Stowell | Nurse Practitioner | 311 Boyd Blvd., La Porte, IN 46350-3965 | 2010-12-17 |
| 1891838629 | Susan K Grace | Nurse Practitioner | 400 Teegarden St, Suite B, La Porte, IN 46350-3175 | 2007-02-14 |
| 1083228399 | April Donald | Nurse Practitioner | 204 Legacy Plz W, La Porte, IN 46350-5285 | 2020-09-03 |
| 1033748736 | Tami Clinkenbeard | Nurse Practitioner | 401 Newporte Blvd, La Porte, IN 46350-4099 | 2020-04-04 |
| 1255963336 | Brittany L. Catizone | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350-3105 | 2020-02-06 |
| 1538704101 | Heidi Marie Bickel | Nurse Practitioner | 311 Boyd Blvd, La Porte, IN 46350-3965 | 2019-11-07 |
| Find all providers in LA PORTE | ||||
Please comment or provide details below to improve the information on TIFFANY BOWEN.
| 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.