MEDICARE: TIFFANY ANN NELSON

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	104100000X	Social Worker	60730	TX

General Provider Information

NPI Number	:	1487511457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY ANN NELSON

Provider Business Mailing Address
First Line	:	2229 SIMS DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5544
Country	:	US
Telephone Number	:	682-215-9348
Fax Number	:	682-215-9348

Provider Business Practice Location Address
First Line	:	2229 SIMS DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5544
Country	:	US
Telephone Number	:	682-215-9348
Fax Number	:	682-215-9348

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/16/2026

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Directions to “ TIFFANY ANN NELSON ” Practice Location

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