Provider Demographics
NPI:1962172148
Name:KURTH-MCNEILL, TIFFANY BRIANNE (PMHNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:BRIANNE
Last Name:KURTH-MCNEILL
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 N CENTRAL AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2806
Mailing Address - Country:US
Mailing Address - Phone:602-230-7373
Mailing Address - Fax:602-257-8029
Practice Address - Street 1:3330 N 2ND ST STE 601
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2395
Practice Address - Country:US
Practice Address - Phone:602-230-7373
Practice Address - Fax:602-230-5105
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ263898363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ263898OtherAMERICAN NURSES CREDENTIALING CENTER: CERTIFIED NURSE PRACTITIONER