MEDICARE: TIFFINEY SMITH THOMPSON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	0024169409	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932487956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFINEY SMITH THOMPSON NP

Provider Business Mailing Address
First Line	:	1080 FIRST COLONIAL RD STE 403
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2406
Country	:	US
Telephone Number	:	757-395-1850
Fax Number	:	855-707-7855

Provider Business Practice Location Address
First Line	:	1080 FIRST COLONIAL RD STE 403
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2406
Country	:	US
Telephone Number	:	757-395-1850
Fax Number	:	855-707-7855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	03/30/2026

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