Provider Demographics
NPI:1386446383
Name:DESCHAMPS, TIFFANY ANN (RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:DESCHAMPS
Suffix:
Gender:
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-4361
Mailing Address - Country:US
Mailing Address - Phone:860-630-0866
Mailing Address - Fax:
Practice Address - Street 1:451 STATE ST STE A
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3070
Practice Address - Country:US
Practice Address - Phone:203-672-2800
Practice Address - Fax:914-393-7519
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT230508163W00000X
CT14633363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner