Provider Demographics
NPI:1780475939
Name:MASSEY, TIFFANY K (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:K
Last Name:MASSEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HILLCREST MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8897
Mailing Address - Country:US
Mailing Address - Phone:254-202-2000
Mailing Address - Fax:
Practice Address - Street 1:7702 CENTRAL PARK DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6535
Practice Address - Country:US
Practice Address - Phone:254-202-7700
Practice Address - Fax:254-202-7710
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty