Provider Demographics
NPI:1053863522
Name:SWEATT, TIFFANY LAUREN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LAUREN
Last Name:SWEATT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BAY ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5181
Mailing Address - Country:US
Mailing Address - Phone:256-543-2894
Mailing Address - Fax:256-543-8185
Practice Address - Street 1:501 BAY ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5181
Practice Address - Country:US
Practice Address - Phone:256-543-2894
Practice Address - Fax:256-543-8185
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-106170363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-106170OtherLICENSE