Provider Demographics
NPI:1386066827
Name:MAAT, TIFFANY N (APRN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:MAAT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:818 N EMPORIA ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3727
Mailing Address - Country:US
Mailing Address - Phone:316-263-5891
Mailing Address - Fax:316-263-3083
Practice Address - Street 1:818 N EMPORIA ST STE 310
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3727
Practice Address - Country:US
Practice Address - Phone:316-263-5891
Practice Address - Fax:316-263-3083
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-76249363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110848015OtherBLUE CROSS AND BLUE SHIELD
KS110848015OtherBLUE CROSS AND BLUE SHIELD