Most Relevant Information
Provider Data
| NPI Number: | 1003114802 |
| Provider Name: | TIFFANY J. VORDERSTRASSE FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 2011006710 |
Most Important Dates
| Enumeration Date: | 03/03/2011 |
| Last Updated: | 12/11/2017 |
Provider Practice Location
105 FAR WEST DR.
STE. 105
ST. JOSEPH
MO
645063514
Practice Location Phone/Fax
| Phone: | 8162718110 |
| Fax: | 8162718104 |
Provider Mailing Location
105 FAR WEST DR STE 105
SAINT JOSEPH
MO
645063514
Provider Mailing Phone/Fax
| Phone: | 8162718115 |
| Fax: | 8162718104 |