Healthcare Provider Details

I. General information

NPI: 1295004778
Provider Name (Legal Business Name): TIFFANY L HURT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY L GREENBERG NP

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

IV. Provider business mailing address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

V. Phone/Fax

Practice location:
  • Phone: 800-997-6196
  • Fax: 415-504-1367
Mailing address:
  • Phone: 800-997-6196
  • Fax: 415-504-1367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024168694
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: