MEDICARE: TIFFANY DIANE COX

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	133V00000X	Registered Dietitian	37001720A	IN

General Provider Information

NPI Number	:	1891420352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY DIANE COX

Provider Business Mailing Address
First Line	:	8054 LITTLE CIRCLE RD
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-1074
Country	:	US
Telephone Number	:	330-219-6286
Fax Number	:

Provider Business Practice Location Address
First Line	:	8440 WOODFIELD CROSSING BLVD STE 175
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-4359
Country	:	US
Telephone Number	:	317-803-6029
Fax Number	:

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

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	07/19/2022

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Directions to “ TIFFANY DIANE COX ” Practice Location

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