MEDICARE: TIFFANY WASHINGTON APN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15291300	NJ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP032924	PA

General Provider Information

NPI Number	:	1386443059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY WASHINGTON APN

Provider Business Mailing Address
First Line	:	6331 ARDLEIGH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-1049
Country	:	US
Telephone Number	:	215-519-8784
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1333
Country	:	US
Telephone Number	:	215-821-7412
Fax Number	:

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

Provider Enumeration Date	:	03/13/2025
Last Update Date	:	02/21/2026

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Directions to “ TIFFANY WASHINGTON APN” Practice Location

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