Provider Demographics
NPI:1548793912
Name:HURD, TIFFANY K (ARNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:K
Last Name:HURD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 MANATEE AVE W STE A
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2357
Mailing Address - Country:US
Mailing Address - Phone:941-761-8505
Mailing Address - Fax:
Practice Address - Street 1:6400 MANATEE AVE W STE A
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2357
Practice Address - Country:US
Practice Address - Phone:941-761-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9234209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily