Organization Name: | TIFFANY ROY, FNP, L.L.C. |
NPI Number: | 1699930719 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIFFANY SMITH ROY (NURSE PRACTITIONER/OWNER) |
Mailing Address: | 9023 Cameron St. Duson |
State: | LA US |
Postal Code: | 70529 |
Phone Number: | 3378738244 |
Fax Number: | 3378738274 |
NPI Enumeration Date: | 07/29/2008 |
NPI Last Update Date: | 11/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 04568 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |