Provider Demographics
NPI:1588014005
Name:LAMOREAUX, TIFFIN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TIFFIN
Middle Name:
Last Name:LAMOREAUX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TIFFIN
Other - Middle Name:DOWLING
Other - Last Name:FARRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:188 HOBCAW DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2545
Mailing Address - Country:US
Mailing Address - Phone:843-442-5008
Mailing Address - Fax:
Practice Address - Street 1:172 RUTLEDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5821
Practice Address - Country:US
Practice Address - Phone:843-442-5008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily