MEDICARE: TIFFANY LYNN GILTNER CRNP

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	SP10176	PA

General Provider Information

NPI Number	:	1720313190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY LYNN GILTNER CRNP

Provider Business Mailing Address
First Line	:	134 POTTSTOWN PIKE
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-9516
Country	:	US
Telephone Number	:	610-458-8881
Fax Number	:	610-458-7184

Provider Business Practice Location Address
First Line	:	4667 W CHESTER PIKE
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2227
Country	:	US
Telephone Number	:	610-356-7870
Fax Number	:	610-594-2625

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

Provider Enumeration Date	:	10/02/2009
Last Update Date	:	09/21/2015

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