Provider Demographics
NPI:1467810358
Name:MURPHY, TIFFANY DANIELLE (NP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DANIELLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 DALLIS ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4401
Mailing Address - Country:US
Mailing Address - Phone:170-629-8491
Mailing Address - Fax:
Practice Address - Street 1:900 DALLIS ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4401
Practice Address - Country:US
Practice Address - Phone:706-298-4914
Practice Address - Fax:706-298-4915
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN199074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily