Provider Demographics
NPI:1134865686
Name:DUFOUR, TIFFANY TUSA (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:TUSA
Last Name:DUFOUR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 W CAUSEWAY APPROACH
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3046
Mailing Address - Country:US
Mailing Address - Phone:985-626-7118
Mailing Address - Fax:985-674-0773
Practice Address - Street 1:1530 W CAUSEWAY APPROACH
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3046
Practice Address - Country:US
Practice Address - Phone:985-626-7118
Practice Address - Fax:985-674-0773
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN122839163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool