Provider Demographics
NPI:1154703718
Name:THOMEN, TIFFANIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:THOMEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TIFFANIE
Other - Middle Name:
Other - Last Name:WESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:21 HAMPTON RD BLDG 2
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4831
Practice Address - Country:US
Practice Address - Phone:603-519-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP161186363L00000X
CA95011458363L00000X
GARN246255363LX0106X
NH089883-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health