| Tiffany Bowen, NP | |
|
508 Legacy Plz W, La Porte, IN 46350-5254 | |
| (219) 575-6244 | |
| (219) 380-0757 |
| Full Name | Tiffany Bowen |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 508 Legacy Plz W, La Porte, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750823795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 28199198A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71006816A (Indiana) | Primary |
| Entity Name | Porter Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508075680 PECOS PAC ID: 1850482407 Enrollment ID: O20070810000409 |
| Entity Name | Chestnut Health Of Indiana Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730884131 PECOS PAC ID: 4183078215 Enrollment ID: O20230923000203 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Bowen, NP 211 N Eddy St, South Bend, IN 46617-2808 Ph: (574) 239-1433 | Tiffany Bowen, NP 508 Legacy Plz W, La Porte, IN 46350-5254 Ph: (219) 575-6244 |
Mrs. Jennifer Campbell, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1509 State Street, La Porte, IN 46350 Phone: 219-324-3431 Fax: 219-362-3802 | |
Tami Clinkenbeard, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 Newporte Blvd, La Porte, IN 46350 Phone: 219-326-1775 Fax: 219-326-1951 | |
Kimberly Minich, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 602 F St, La Porte, IN 46350 Phone: 219-324-1377 | |
Fabienne Fify, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1700 I St, La Porte, IN 46350 Phone: 708-288-5036 | |
April Donald, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 204 Legacy Plz W, La Porte, IN 46350 Phone: 219-476-7246 | |
Mrs. Tina Marie Pierce, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 809 Jefferson Ave, La Porte, IN 46350 Phone: 219-878-5645 | |
Sandra R Gates-manna, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1509 State St, La Porte, IN 46350 Phone: 219-325-5434 Fax: 219-325-7655 |