Provider Demographics
NPI:1376986257
Name:TIFFANY ROY FNP LLC
Entity Type:Organization
Organization Name:TIFFANY ROY FNP LLC
Other - Org Name:DUSON FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:337-873-8244
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-0370
Mailing Address - Country:US
Mailing Address - Phone:337-873-8244
Mailing Address - Fax:337-873-8274
Practice Address - Street 1:110 W. FIRST ST
Practice Address - Street 2:SUITE A
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529
Practice Address - Country:US
Practice Address - Phone:337-873-8244
Practice Address - Fax:337-873-8274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health