MEDICARE: TIFFANY SCOTT MSN-ED, 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1124668678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY SCOTT MSN-ED, RN

Provider Business Mailing Address
First Line	:	440 BENMAR DR STE 1395
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3172
Country	:	US
Telephone Number	:	832-359-6670
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 BENMAR DR STE 1395
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3172
Country	:	US
Telephone Number	:	832-329-5646
Fax Number	:	844-273-8121

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

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	01/29/2020

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