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NPI Code Detail

MEDICARE: MRS. TIFFANY JEAN YAN PA-C

MEDICARE:  MRS. TIFFANY JEAN YAN  PA-C
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
1363A00000XPhysician AssistantPA0005373CO
2363A00000XPhysician AssistantPA60325568WA
3363A00000XPhysician Assistant2388NE

General Provider Information

NPI Number : 1760723522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY JEAN YAN PA-C
Provider Business Mailing Address
First Line : 11880 AIRPORT WAY
Second Line :
City : BROOMFIELD
State : CO
Zip : 80021-2767
Country : US
Telephone Number : 720-432-4419
Fax Number : 308-646-0168
Provider Business Practice Location Address
First Line : 2101 BOX BUTTE AVE
Second Line :
City : ALLIANCE
State : NE
Zip : 69301-4444
Country : US
Telephone Number : 308-762-6660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2013
Last Update Date : 07/12/2024

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Directions to “ MRS. TIFFANY JEAN YAN PA-C” Practice Location

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