Tiffany Lynne Brokaw, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

462035 Issued in CA

Practice address

411 Tanglewood CT
Paso Robles, CA 93446-4486

Phone

(805) 540-8452

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1295323913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 TANGLEWOOD CT",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934464486",
            "telephone_number": "805-540-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 TANGLEWOOD CT",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934464486",
            "telephone_number": "805-540-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKAW",
        "first_name": "TIFFANY",
        "middle_name": "LYNNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "462035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Paso Robles, CA
• General Practice Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.