Tiffany Jean Tate, M.ED.
Individual provider Active NPI Respite Care · Wilson, WY
NPI 1609021823 · NPPES record last updated Dec 2, 2008
Key facts
- NPI
- 1609021823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Respite Care 385H00000X
- License
- 385H00000X (WY)
- Practice address
- 2245 Coyote Loop
Wilson, WY 83014-9668 - Phone
- (307) 690-6189
- NPI assigned
- Dec 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 385H00000X | WY | MD | Respite Care |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | 385H00000X | WY | Yes |
Addresses
Primary practice location
2245 Coyote Loop
Wilson, WY 83014-9668
Mailing address
2245 Coyote Loop
Wilson, WY 83014-9668
Phone (307) 690-6189
Other providers in Wilson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.