Healthcare Provider Details

I. General information

NPI: 1154254308
Provider Name (Legal Business Name): MRS. TIFFANY CASANDRA VOLLMERHAUSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 BEDFORD ST
CUMBERLAND MD
21502-1007
US

IV. Provider business mailing address

705 LOUISIANA AVE
CUMBERLAND MD
21502-3637
US

V. Phone/Fax

Practice location:
  • Phone: 240-803-7222
  • Fax:
Mailing address:
  • Phone: 301-268-9663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: