Tiffany Halliburton

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R198341 Issued in MD

Practice address

7503B Annapolis Rd
Hyattsville, MD 20784-1701

Phone

(240) 296-1112

Fax

(240) 296-1097

NPI assigned

Sep 28, 2015

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 MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1891165346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-933-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503B ANNAPOLIS RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841701",
            "telephone_number": "240-296-1112",
            "fax_number": "240-296-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "TIFFANY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R198341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Halback and Associates LLC
• Halback and Associates LLC
• Kim Halback, LICSW
• Brittany Hall
• Dominique Crystal Hallany, HHA
• Juliet Halloulell
• Miranda Hallowell
• Allana Hamilton
• Georgette Marieatta Hamilton, LICSW, LCSW
• Tamika Nikia Hamilton

• Family Nurse Practitioner in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.