Healthcare Provider Details

I. General information

NPI: 1881538874
Provider Name (Legal Business Name): MRS. TIFFANY SHARI BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON AVE S STE 1210
MINNEAPOLIS MN
55401-2104
US

IV. Provider business mailing address

8875 MANAHAN DR
ELLICOTT CITY MD
21043-5400
US

V. Phone/Fax

Practice location:
  • Phone: 800-925-3368
  • Fax:
Mailing address:
  • Phone: 864-404-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR223623
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: