Healthcare Provider Details

I. General information

NPI: 1932102381
Provider Name (Legal Business Name): TIFFANY NICOLE ENGELKEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY NICOLE FELDKAMP APRN

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 COMMUNITY DR
SENECA KS
66538-9739
US

IV. Provider business mailing address

1600 COMMUNITY DR
SENECA KS
66538-9739
US

V. Phone/Fax

Practice location:
  • Phone: 785-336-6181
  • Fax: 785-336-2578
Mailing address:
  • Phone: 785-336-6181
  • Fax: 785-336-2578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45471
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: