TIFFANY LEE BOULANGER (NPI# 1700308509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700308509 |
| Entity Type | Individual |
| Full Name | TIFFANY LEE BOULANGER |
| Credential | AGACNP |
| Practice Address |
12345 Mercy Blvd Savannah GA 31419-3436 |
| Mailing Address |
7400 Abercorn Street Ste 704 Box 104 Savannah GA 31406-2454 |
| Practice Telephone | 9129273046 |
| Mailing Telephone | 9122329700 |
| Mailing Fax Number | 9127480270 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
236517 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12345 MERCY BLVD |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-3436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548267438 | Savannah Diagnostic Assoc PC | Specialist | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2005-07-07 |
| 1760046452 | Dannyel Smith | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2019-04-28 |
| 1518466556 | Katherine Ireland Klick | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2018-02-05 |
| 1023232527 | John David Northup | Internal Medicine | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811682 | Ashlee Renee Mack | Nurse Practitioner | 116 Slate Cir, Savannah, GA 31419-9681 | 2020-08-16 |
| 1861038044 | Mara Dawne Carson | Nurse Practitioner | 1515 Benton Blvd Apt 1328, Savannah, GA 31407-0440 | 2019-11-21 |
| 1710534474 | Aaron Montover | Nurse Practitioner | 225 Candler Dr Ste 301, Savannah, GA 31405-6091 | 2019-08-19 |
| 1407227994 | James Doyle Herring IIi | Nurse Practitioner | 302 Surrey Rd, Savannah, GA 31410-4407 | 2015-10-09 |
| 1649646688 | Susan Ahle | Nurse Practitioner | 8 Dockside Dr, Savannah, GA 31410-2536 | 2015-08-13 |
| 1912554841 | Haley Brooke Mccain | Nurse Practitioner | 1326 Eisenhower Dr Bldg 2, Savannah, GA 31406-3928 | 2019-08-26 |
| 1356993679 | Lana Marie Stark | Nurse Practitioner | 107 Southern Blvd, Savannah, GA 31405-7437 | 2019-07-16 |
| 1205383130 | Beverly J Lippert | Nurse Practitioner | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2016-09-08 |
| 1679956056 | Stacy Creel | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2015-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032114 | Candace Buckley | Nurse Practitioner | 244 Ashland Dr, Woodstock, GA 30189-7161 | 2020-10-29 |
| 1679170740 | Jennifer Lassiter | Nurse Practitioner | 4116 Holley Rd., Lizella, GA 31052 | 2020-10-02 |
| 1891301164 | Tashoy Wallace | Nurse Practitioner | 121 Odyssey Turn, Conyers, GA 30012-3681 | 2020-09-21 |
| 1912513672 | Katherine Anne Sego | Nurse Practitioner | 4060 Rolling Meadows Ln, Watkinsville, GA 30677-3011 | 2020-09-18 |
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1588276505 | Sherron Johnson | Nurse Practitioner | 1980 Wrights Way, Jonesboro, GA 30236-7205 | 2020-08-20 |
| 1467063610 | Rosa Maria Phillips | Nurse Practitioner | 649 Amicalola Woods Rd, Dawsonville, GA 30534-1205 | 2020-08-12 |
| 1508476581 | Jarvis Reese | Nurse Practitioner | 413 Tug Ct, Warner Robins, GA 31088-2134 | 2020-08-05 |
| 1750991790 | Akosua Frema Sarfo | Nurse Practitioner | 116 Ginkgo Ln, Grovetown, GA 30813-5392 | 2020-08-04 |
| 1851919039 | Robert Brant | Nurse Practitioner | 20 Fairway Oaks, Waverly, GA 31565-2767 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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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.