Provider Demographics
NPI:1538922307
Name:NOBLE, TIFFANY P (FNP)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:P
Last Name:NOBLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4303
Mailing Address - Country:US
Mailing Address - Phone:347-392-9443
Mailing Address - Fax:
Practice Address - Street 1:5645 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:FORT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640-5402
Practice Address - Country:US
Practice Address - Phone:609-316-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348617363LF0000X
NJ26NJ14935500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily