Provider Demographics
NPI:1376063404
Name:HORNE, TIFFANI (BS RRT)
Entity type:Individual
Prefix:MRS
First Name:TIFFANI
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:BS RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 S 2025 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-3307
Mailing Address - Country:US
Mailing Address - Phone:801-814-2127
Mailing Address - Fax:
Practice Address - Street 1:4885 S 900 E STE 107
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-3905
Practice Address - Country:US
Practice Address - Phone:801-266-0399
Practice Address - Fax:801-266-0421
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4861666-5701227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered