MEDICARE: TIFFANI N MUHAMMAD FNP-BC, 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	363LF0000X	Family Nurse Practitioner	R187393	MD

General Provider Information

NPI Number	:	1104123108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANI N MUHAMMAD FNP-BC, RN

Provider Business Mailing Address
First Line	:	5557 BALTIMORE AVE STE 500-927
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20781-1922
Country	:	US
Telephone Number	:	240-419-4509
Fax Number	:

Provider Business Practice Location Address
First Line	:	5557 BALTIMORE AVE STE 500-927
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20781-1922
Country	:	US
Telephone Number	:	240-419-4509
Fax Number	:

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

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	12/14/2021

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