Tiffany Brannan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7968 Issued in MN

Practice address

119 Paul Bunyan Dr NW
Ste a, PMB 1008
Bemidji, MN 56601

Phone

(218) 203-5449

NPI assigned

Mar 12, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MN

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1447835285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PAUL BUNYAN DR NW",
            "address_2": "STE A, PMB 1008",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PAUL BUNYAN DR NW",
            "address_2": "STE A, PMB 1008",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-203-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Bowman, MS, LMFT
• Brandon Boyd
• Aleasha Bradseth
• Tashina Lerae Branchaud, LSW, LADC, CADCII
• Myles Brandt
• James Braunwarth, M.D.
• Angela K. Brekken, EDD MS RD LD FAND
• Angela Jo Bremer, DC
• Jeffrey James Breyen
• Brian W Truax

• Family Nurse Practitioner in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.