Provider Demographics
NPI:1689470957
Name:WHORTON, TIFFANY AMBER (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:AMBER
Last Name:WHORTON
Suffix:
Gender:
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 BOLSER ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-1209
Mailing Address - Country:US
Mailing Address - Phone:660-973-0047
Mailing Address - Fax:
Practice Address - Street 1:1606 BOLSER ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-1209
Practice Address - Country:US
Practice Address - Phone:660-973-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024048239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily