# TIFFANY K MAIN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1750327706
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 45333 | KS | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 03/16/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100429300A | — | KS |
| 05 | — | 100850610A | — | OK |
| 01 | — | 160904 | KS BCBS | KS |
| 05 | — | 425962602 | — | MO |
| 01 | — | 500027083 | RR MEDICARE | — |