Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tiffany Lack, APRN, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1700431723

Tiffany Lack, APRN, FNP-BC is a Nurse Practitioner in Maumelle, Arkansas. Qualified in 2019, 7 years ago. Practices with Maumelle Family Medicine LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
7
Licensed in
AR
In the registry since
2019
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

See every abbreviation used in this directory →

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Practice location Address checks out

2001 Club Manor Dr Ste S
Maumelle, AR 72113-7417
Phone: (501) 734-8085
Fax: (501) 734-8085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 123569 (AR)

Record details

NPI number1700431723
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN , FNP-BC
Sole proprietorNo
NPI enumeratedAugust 6, 2019
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Maumelle Family Medicine Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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