TIFFANY BRACKUS (FNP) – Family Nurse Practitioner, NPI 1194336339

TIFFANY BRACKUS (FNP) is a healthcare provider. based in Nampa, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. TEMP65467 (ID). The NPI Number for TIFFANY BRACKUS (FNP) is 1194336339

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY BRACKUS (FNP)
NPI
1194336339
Phone
(208) 461-7149
Address
PO BOX 9
Enumeration Date
12 August 2020
Last Update Date
28 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2084667869
Graduation Year
2020 (6 years ago)
PAC ID
6204249790
Group Practice PAC ID
4082527353
Professional Enrollment ID
I20220607001340
Address ID
ID836513703NA207XXSXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

1,798 NURSE PRACTITIONER in ID

Provider Addresses for TIFFANY BRACKUS (FNP)

  • PO BOX 9

    NAMPA, ID 836530009

    Phone: (208) 461-7149

    Fax: (208) 467-3391

    Type: Mailing

  • 207 1ST ST S

    NAMPA, ID 836513703

    Phone: (208) 466-7869

    Fax: (208) 466-0009

    Type: Location

  • 790 E 5TH ST

    COQUILLE, OR 974231755

    Phone: (541) 396-3111

    Fax: (541) 936-5891

    Type: Mailing

  • 790 E 5th St

    Coquille, OR 974231755

    Phone: (541) 396-3111

    Fax: (541) 396-5891

    Type: Location

  • 223 16th Ave N

    Nampa, ID 836874058

    Phone: (208) 467-7654

    Fax: (208) 466-5359

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-06-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220607001340INurse PractitionerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83653)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082527353View full group profile

Reviews

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Frequently asked questions

How is TIFFANY BRACKUS (FNP) identified in CMS data?
CMS-hosted NPPES data lists TIFFANY BRACKUS (FNP) with NPI 1194336339.
Is TIFFANY BRACKUS (FNP) listed as active for patients and plans?
The listing shows TIFFANY BRACKUS (FNP) as active in the NPI system.
What is TIFFANY BRACKUS (FNP) best known for clinically?
Directory data describes TIFFANY BRACKUS (FNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is TIFFANY BRACKUS (FNP) based?
TIFFANY BRACKUS (FNP) is tied to Nampa, Idaho in the data we show; additional addresses may exist on the full record.
Is the information about TIFFANY BRACKUS (FNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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