Provider Demographics
NPI:1982443263
Name:HOTCHKIN, TIFFANY RAE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:RAE
Last Name:HOTCHKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 31ST AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6206
Mailing Address - Country:US
Mailing Address - Phone:701-541-8078
Mailing Address - Fax:
Practice Address - Street 1:3317 31ST AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6206
Practice Address - Country:US
Practice Address - Phone:701-541-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant