Provider Demographics
NPI:1457185332
Name:TURNER, TIFFANIE NICOLE (PBT)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:NICOLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13509 LBJ FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4704
Mailing Address - Country:US
Mailing Address - Phone:469-652-2504
Mailing Address - Fax:
Practice Address - Street 1:13509 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-4704
Practice Address - Country:US
Practice Address - Phone:469-652-2504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50957246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy