Provider Demographics
NPI:1538604988
Name:LIBBY, TIFFANY ELIZABETH (MSN, APN, CEN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ELIZABETH
Last Name:LIBBY
Suffix:
Gender:F
Credentials:MSN, APN, CEN, FNP-C
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:STUDENT HEALTH, LOYOLA OUTPATIENT CENTER, 3RD FLOOR
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-3156
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:STUDENT HEALTH, LOYOLA OUTPATIENT CENTER, 3RD FLOOR
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209.014417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily