Provider Demographics
NPI:1760809412
Name:ONEY, TIFFANIE
Entity Type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:ONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N SECTION LINE RD
Mailing Address - Street 2:
Mailing Address - City:VALLIANT
Mailing Address - State:OK
Mailing Address - Zip Code:74764-9047
Mailing Address - Country:US
Mailing Address - Phone:580-933-6724
Mailing Address - Fax:
Practice Address - Street 1:204 N SECTION LINE RD
Practice Address - Street 2:
Practice Address - City:VALLIANT
Practice Address - State:OK
Practice Address - Zip Code:74764-9047
Practice Address - Country:US
Practice Address - Phone:580-933-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program