Provider Demographics
NPI:1992562151
Name:CASHDOLLAR, TIFFANY IVA (CRNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:IVA
Last Name:CASHDOLLAR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:IVA
Other - Last Name:WALTENBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 SPORTSMAN RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-4555
Mailing Address - Country:US
Mailing Address - Phone:724-954-4416
Mailing Address - Fax:
Practice Address - Street 1:300 MEDICAL ARTS BLDG STE 300
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7129
Practice Address - Country:US
Practice Address - Phone:724-545-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily