Healthcare Provider Details

I. General information

NPI: 1669928149
Provider Name (Legal Business Name): TIFFANY ZAMPINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N 17TH AVE
GREELEY CO
80631-9117
US

IV. Provider business mailing address

831 BOLTZ DR
FORT COLLINS CO
80525-2704
US

V. Phone/Fax

Practice location:
  • Phone: 970-304-6420
  • Fax:
Mailing address:
  • Phone: 970-366-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1624453
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: