Provider Demographics
NPI:1295044584
Name:JERNIGAN, TIFFANY JENNA (DPT)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:JENNA
Last Name:JERNIGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3734
Mailing Address - Country:US
Mailing Address - Phone:615-890-2020
Mailing Address - Fax:
Practice Address - Street 1:100 E VINE ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3734
Practice Address - Country:US
Practice Address - Phone:615-893-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist