Provider Demographics
NPI:1063033108
Name:REFFIT, TIFFANY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:REFFIT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16016 LEMOYNE BLVD APT 605
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5182
Mailing Address - Country:US
Mailing Address - Phone:228-234-4666
Mailing Address - Fax:
Practice Address - Street 1:4300 15TH ST STE B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2524
Practice Address - Country:US
Practice Address - Phone:228-864-0828
Practice Address - Fax:228-864-0191
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily