MEDICARE: MRS. TIFFANY GERI BROWN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN637421	PA

General Provider Information

NPI Number	:	1053647875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY GERI BROWN RN

Provider Business Mailing Address
First Line	:	313 BAINBRIDGE ST FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1542
Country	:	US
Telephone Number	:	267-536-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 BAINBRIDGE ST FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1542
Country	:	US
Telephone Number	:	267-536-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	07/17/2023

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