Provider Demographics
NPI:1235168147
Name:TAYLOR, TIFFANY DIANE (DC, APC)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:DIANE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC, APC
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:D
Other - Last Name:TAYLOR-MURRISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, APC
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-1514
Mailing Address - Country:US
Mailing Address - Phone:575-739-2225
Mailing Address - Fax:575-739-0039
Practice Address - Street 1:201 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:NM
Practice Address - Zip Code:88260-4020
Practice Address - Country:US
Practice Address - Phone:575-739-2225
Practice Address - Fax:575-739-0039
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9244111N00000X
NM1658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1427079433OtherBACK IN MOTION NPI
NM1658OtherDR MURRISH NM LICENSE NR
TX9244OtherDR MURRISH TX LICENSE NR.
TX9244OtherDR MURRISH TX LICENSE NR.
TX609759Medicare PIN
NM349802502Medicare PIN