Provider Demographics
NPI:1861569907
Name:ANDERSON-KATHER, TIFFANY ANN (FNP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ANN
Last Name:ANDERSON-KATHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:KATHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4496 N WOODBURN ST
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211
Mailing Address - Country:US
Mailing Address - Phone:414-964-2432
Mailing Address - Fax:
Practice Address - Street 1:3220 W VLIET ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2453
Practice Address - Country:US
Practice Address - Phone:414-231-4000
Practice Address - Fax:414-231-4010
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1848033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily