Provider Demographics
NPI:1679074819
Name:DUVALL, TIFFANY MICHELLE ARNOLD (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:MICHELLE ARNOLD
Last Name:DUVALL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35381 LIVE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-1500
Mailing Address - Country:US
Mailing Address - Phone:225-405-8046
Mailing Address - Fax:
Practice Address - Street 1:29680 SOUTH FROST ROAD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754
Practice Address - Country:US
Practice Address - Phone:225-686-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist