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General NPI Number Information
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NPI Number | 1538302070
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Entity Type | Individual
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Provider Name | TIFFANY NICOLE RYBAK CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 3950 N A W GRIMES BLVD STE N201
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City | ROUND ROCK
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State | TX
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Zip | 78665-3540
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Country | US
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Telephone | 877-800-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 2423 WILLIAMS DR STE 107
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City | GEORGETOWN
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State | TX
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Zip | 78628-3269
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Country | US
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Telephone | 877-800-5722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | COA13571NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | COA-13571
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1198422
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License Number State | TX
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