Individual provider · Type 1 NPI

Tiffany Nicole Logan, NP

Primary Care Nurse Practitioner · Champaign, IL

NPI number 1790359495 Active

Practice location

1701 Curtis Rd
Champaign, IL 61822-9678

Mailing address

2302 Belmore Dr
Champaign, IL 61821

Other practice locations

  • 201 N Randolph St, Champaign, IL 61820-3935 · (877) 726-6494

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X209.021232 (IL)

Primary Care Nurse Practitioner: Definition to come...

60 other providers at this address

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About NPI 1790359495

Tiffany Nicole Logan, NP's National Provider Identifier is 1790359495, issued on May 17, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Champaign, IL. The record was last updated on Dec 8, 2022.