Provider Demographics
NPI:1265003180
Name:SARIC, TIFFANY CRYSTAL (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:CRYSTAL
Last Name:SARIC
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 HIGHWAY 5 N STE 10
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3039
Mailing Address - Country:US
Mailing Address - Phone:870-232-0900
Mailing Address - Fax:870-232-0888
Practice Address - Street 1:330 HIGHWAY 5 N STE 10
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3039
Practice Address - Country:US
Practice Address - Phone:870-232-0900
Practice Address - Fax:870-232-0888
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR216202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily