Provider Demographics
NPI:1437507498
Name:WOODY, TIFFANY (FNP-C)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:WOODY
Suffix:
Gender:F
Credentials: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:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705-0027
Mailing Address - Country:US
Mailing Address - Phone:828-688-2104
Mailing Address - Fax:828-688-1334
Practice Address - Street 1:71 BLUE RIDGE LN
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7270
Practice Address - Country:US
Practice Address - Phone:828-682-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily