Healthcare Provider Details

I. General information

NPI: 1841867389
Provider Name (Legal Business Name): TIFFANI J. TOBE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 MCCORD WAY APT 1222
FRISCO TX
75033-1180
US

IV. Provider business mailing address

1801 MCCORD WAY APT 1222
FRISCO TX
75033-1180
US

V. Phone/Fax

Practice location:
  • Phone: 317-525-1033
  • Fax:
Mailing address:
  • Phone: 317-525-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number71011144A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number1117645
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: