Provider Demographics
NPI:1346012143
Name:CROWE, TIFFANIE BETH
Entity Type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:BETH
Last Name:CROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TIFFANIE
Other - Middle Name:BETH
Other - Last Name:COUEY-LENHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5629
Mailing Address - Country:US
Mailing Address - Phone:405-978-8204
Mailing Address - Fax:405-600-3105
Practice Address - Street 1:1215 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-5629
Practice Address - Country:US
Practice Address - Phone:405-978-8204
Practice Address - Fax:405-600-3105
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0094600163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)