Provider Demographics
NPI:1164081048
Name:BARNETT, TIFFANI NICHOLE (CNM)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:NICHOLE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:TIFFANI
Other - Middle Name:NICHOLE
Other - Last Name:MUNCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:603 E LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3737
Mailing Address - Country:US
Mailing Address - Phone:229-938-3444
Mailing Address - Fax:
Practice Address - Street 1:603 E LAMAR ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3737
Practice Address - Country:US
Practice Address - Phone:229-928-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224980367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife