Doctor Name: | TIFFANY SANDLIN STIVERS |
NPI Number: | 1093175754 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | RN232674 |
Business Practice Address: | 3340 Paddock Pkwy Suwanee, GA - 300249119 |
Business Phone Number: | 6786795240 |
Business Fax Number: | |
Mailing Address: | 3340 Paddock Pkwy, SUWANEE |
State: | GA |
Postal Code: | 300249119 |
Phone Number: | 6786795240 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2016 |
NPI Last Update Date: | 02/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN232674 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |