Provider Demographics
NPI:1518758127
Name:MAHER, TIFFANY A (CNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:MAHER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3500 AMERICAN BLVD W STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-4442
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:
Practice Address - Street 1:3470 WASHINGTON DR STE 201
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1354
Practice Address - Country:US
Practice Address - Phone:651-227-7806
Practice Address - Fax:651-256-6744
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN12904363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics