Provider Demographics
NPI:1003680125
Name:RILEY, TIFFANY TAGGART (DNP, FNP-BC, APRN)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:TAGGART
Last Name:RILEY
Suffix:
Gender:F
Credentials:DNP, FNP-BC, APRN
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:AMBER
Other - Last Name:TAGGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4261 STOCKTON DR STE LL100
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2966
Mailing Address - Country:US
Mailing Address - Phone:501-975-7456
Mailing Address - Fax:
Practice Address - Street 1:9601 BAPTIST HEALTH DR STE 860
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6375
Practice Address - Country:US
Practice Address - Phone:501-975-7456
Practice Address - Fax:501-978-1822
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR230675363L00000X
ARR107327163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WS0200XNursing Service ProvidersRegistered NurseSchool