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Individual
TIFFANY BALLENTINE
Active
Individual
TIFFANY BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9435094
FL
363LF0000X
Family Nurse Practitioner
Primary
11018629
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11018629
APRN LICENSE
FL
01
—
9435094
RN LICENSE
FL
Enumeration date
03/23/2022
Last updated
08/12/2026
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