Provider Demographics
NPI:1083099188
Name:L'ROY, TIFFANY JEAN (APRN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JEAN
Last Name:L'ROY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:JEAN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1359 W AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2935
Mailing Address - Country:US
Mailing Address - Phone:661-726-5000
Mailing Address - Fax:661-726-4347
Practice Address - Street 1:1359 W AVENUE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2935
Practice Address - Country:US
Practice Address - Phone:661-726-5000
Practice Address - Fax:661-726-4347
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128419363LF0000X
CA95009566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily