Tiffany Lack, APRN, FNP-BC in Maumelle, AR - Medicare Nurse Practitioner

Tiffany Lack, APRN, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Maumelle, Arkansas. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Maumelle Family Medicine Llc and her current practice location is 2001 Club Manor Dr Ste S, Maumelle, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 734-8085.

Tiffany Lack is licensed to practice in Arkansas (license number 123569) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1700431723.

Contact Information

	Tiffany Lack, APRN, FNP-BC
	2001 Club Manor Dr Ste S, Maumelle, AR 72113-7417
	(501) 734-8085
	(501) 734-8085

Map and Direction

Provider's Profile

Full Name	Tiffany Lack
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	2001 Club Manor Dr Ste S, Maumelle, Arkansas
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tiffany Lack graduated from nursing school in 2019

NPI Data:

NPI Number: 1700431723
Provider Enumeration Date: 08/06/2019
Last Update Date: 04/24/2024

Medicare PECOS Information:

PECOS PAC ID: 3779913207
Enrollment ID: I20200423001120

Medical Identifiers

Medical identifiers for Tiffany Lack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700431723	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	123569 (Arkansas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Maumelle Family Medicine Llc	0941649073	2

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tiffany Lack allows following entities to bill medicare on her behalf.

Entity Name	Tracy Thomas Phillips
Entity Type	Practitioner - Family Practice
Entity Identifiers	NPI Number: 1679571863 PECOS PAC ID: 2163555319 Enrollment ID: I20100809000688

Entity Name	Natural State Health Center, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912141730 PECOS PAC ID: 4082800818 Enrollment ID: O20101119000023

Entity Name	Maumelle Family Medicine Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033969290 PECOS PAC ID: 0941649073 Enrollment ID: O20240422002230

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tiffany Lack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Tiffany Lack, APRN, FNP-BC 2001 Club Manor Dr Ste S, Maumelle, AR 72113-7417 Ph: (501) 734-8085	Tiffany Lack, APRN, FNP-BC 2001 Club Manor Dr Ste S, Maumelle, AR 72113-7417 Ph: (501) 734-8085

Reviews and Comments

Nurse Practitioner Nurses in Maumelle, AR

Mrs. Rachael Constance Curtis, APRN-CNP, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1701 Club Manor Dr Ste 2, Maumelle, AR 72113 Phone: 501-851-7400
Laura Farley, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1701 Club Manor Dr Ste 2, Maumelle, AR 72113 Phone: 501-851-7400 Fax: 501-851-4753
Mrs. Mary Ann Garnica, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 22 Ouachita Dr, Maumelle, AR 72113 Phone: 918-978-9555
Laura Nicole Stallings, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2001 Club Manor Dr Ste S, Maumelle, AR 72113 Phone: 501-734-8085 Fax: 501-734-8088
Toronsa Mechel Simpson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19 Prince Dr, Maumelle, AR 72113 Phone: 501-319-4717
Mrs. Elizabeth Ann Kirk, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8060 Counts Massie Rd Integrated Care Professionals, Maumelle, AR 72113 Phone: 479-968-8279 Fax: 479-250-0500
Stacy Graham, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 17 Saint Thomas Dr, Maumelle, AR 72113 Phone: 501-912-2362

Tiffany Lack, APRN, FNP-BC - Medicare Nurse Practitioner in Maumelle, AR