MS. TIFFANY SIDRA TAYLOR-MDUBA APRN NPI 1508500760

NPI Information

NPI: 1508500760
Provider Name: MS. TIFFANY SIDRA TAYLOR-MDUBA, APRN
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
58375 TWENTYNINE PALMS HWY
SUITE B
YUCCA VALLEY, CA
ZIP 92284
Phone: (760) 365-9305
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MS. Tiffany Sidra Taylor-mduba, APRN is a pediatrics nurse practitioner in Yucca Valley, CA. MS. Tiffany Sidra Taylor-mduba, APRN NPI is 1508500760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

58375 TWENTYNINE PALMS HWY
SUITE B
YUCCA VALLEY, CA
ZIP 92284
Phone: (760) 365-9305

The NPI 1508500760 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/25/2022 and was last updated on 4/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		818748	CALIFORNIA	No
2	363LP0200X	Nurse Practitioner	Pediatrics	95020695	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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