TIFFANY WARGO (NPI# 1104361880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104361880 |
Entity Type | Individual |
Full Name | TIFFANY WARGO |
Credential | APRN |
Practice Address |
300 S School St Dermott AR 71638-2127 |
Mailing Address |
Po Box 509 Dermott AR 71638-0509 |
Practice Telephone | 8705383355 |
Mailing Telephone | 8705385414 |
Enumeration Date | 2017-01-04 |
Last Update Date | 2017-01-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A004906 | AR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
300 S SCHOOL ST |
City | DERMOTT |
State | AR |
Zip Code | 71638-2127 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386758043 | Mainline Health Systems Inc | Clinic/Center | 300 S School St, Dermott, AR 71638-2228 | 2006-08-19 |
1962044800 | Charlie J Gober | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-10-11 |
1710448535 | Clark N Roberts | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-03-26 |
1205315637 | Kimberly Weeks | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-08-07 |
1184102303 | William Joshua Hunter | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-07-31 |
1386026359 | Courtney Shay Johnson | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2015-06-25 |
1669886552 | Shenika Jackson-king | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2014-06-18 |
1821409996 | Crystal Little | Pediatrics | 300 S School St, Dermott, AR 71638-2127 | 2014-05-12 |
1659710879 | Dana Shea Phillips | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2013-06-20 |
1003021692 | Gary Dalton | Dentist | 300 S School St, Dermott, AR 71638-2127 | 2007-05-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
1134286750 | Dermott City Nursing Home | Skilled Nursing Facility | 702 West Gaines St., Dermott, AR 71638 | 2007-01-02 |
1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
1780119610 | Medical Transport Management, Inc | Ambulance | 109 W Peddicord St, Dermott, AR 71638-2115 | 2017-04-28 |
Find all providers in zip 71638 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720611361 | Jamie L Cagle | Nurse Practitioner | 1500 Dodson Ave # 60, Fort Smith, AR 72901-5182 | 2020-02-21 |
1306489281 | Lawana Bradley | Nurse Practitioner | 296 Lake Rd, Atkins, AR 72823-7165 | 2019-10-23 |
1679116024 | Michelle Grant | Nurse Practitioner | 130 Mark Cir, Monticello, AR 71655-5617 | 2019-10-17 |
1780238782 | Chelsea D. Marquis | Nurse Practitioner | 4401 Sw Flagstone Blvd, Bentonville, AR 72713-4005 | 2019-07-29 |
1265094478 | Kristyn Clark | Nurse Practitioner | 210 S Thompson St, Springdale, AR 72764-4239 | 2019-07-08 |
1184194029 | Stephanie Lucille Converse | Nurse Practitioner | 326 Lee Rd # 601, Brickeys, AR 72320-8000 | 2018-12-04 |
1174026165 | Phoebe Grace Chandler | Nurse Practitioner | 3782 Solitude St, Springdale, AR 72764-6368 | 2018-03-15 |
1386143717 | Andrew Freeman Oliver | Nurse Practitioner | 650 United Dr Ste 200, Conway, AR 72032-7001 | 2018-02-12 |
1760908982 | Jamie Leigh Ferguson | Nurse Practitioner | 4301 W Markham St # 721-3, Little Rock, AR 72205-7101 | 2017-08-18 |
1336677731 | Robert Lee Mcgruder Jr. | Nurse Practitioner | 2308 Royal Ct Unit B, Bryant, AR 72022-4216 | 2017-05-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.