Healthcare Provider Details

I. General information

NPI: 1396244737
Provider Name (Legal Business Name): TIFFANY MCROBERTS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2018
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 SANDERS ST
BURLINGTON KS
66839-2616
US

IV. Provider business mailing address

309 SANDERS ST
BURLINGTON KS
66839-2616
US

V. Phone/Fax

Practice location:
  • Phone: 620-364-5395
  • Fax:
Mailing address:
  • Phone: 620-364-5395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78062-011
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: