Provider Demographics
NPI:1891517355
Name:SUMPTER, TIFFINY SHANNA (DNP, CRNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:TIFFINY
Middle Name:SHANNA
Last Name:SUMPTER
Suffix:
Gender:
Credentials:DNP, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8095 SANDPIPER CIR APT 410
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5060
Mailing Address - Country:US
Mailing Address - Phone:443-909-8586
Mailing Address - Fax:
Practice Address - Street 1:7952 HARFORD RD
Practice Address - Street 2:SUITE B/C-2ND FLOOR
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234
Practice Address - Country:US
Practice Address - Phone:844-481-0217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily