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Tiffaney N White

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

14000 Jericho Park Rd, Bowie, MD 20715-3319

PECOS Enrollment

This provider is enrolled in PECOS as TIFFANEY WHITE.

Based on the most recent information from CMS, provider Tiffaney N White is legally eligible to order and refer claims for HHA, DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1043941743
Provider Type
Individual
Full Name
White, Tiffaney N
Gender
Female

Sole Proprietor
Yes
Enumeration Date
6/22/2022
Last Updated
8/24/2025

Contact Information

Practice Location

14000 Jericho Park Rd, Bowie, MD 20715-3319

(301) 860-4000

Unlisted Fax

Mailing Location

14000 Jericho Park Rd, Bowie, MD 20715-3319

(301) 860-4000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License RN212898 Maryland

Tiffaney N White

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

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License

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