Healthcare Provider Details

I. General information

NPI: 1609007228
Provider Name (Legal Business Name): TIFFANY LAYNE HUXMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E 1ST ST
NEWTON KS
67114-5010
US

IV. Provider business mailing address

PO BOX 700
HESSTON KS
67062-0700
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-6400
  • Fax: 316-284-6490
Mailing address:
  • Phone: 620-386-6522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5374984102
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-74984
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: