Tiffany M Theard, MS, FNP-C, RN, CRRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11012639 Issued in FL

Practice address

5033 Beauclair St
Kissimmee, FL 34758-2337

Phone

(262) 496-6532

NPI assigned

Sep 24, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1285060079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5033 BEAUCLAIR ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347582337",
            "telephone_number": "262-496-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5033 BEAUCLAIR ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347582337",
            "telephone_number": "262-496-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEARD",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "MS, FNP-C, RN, CRRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9560905",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.