Provider Demographics
NPI:1457586133
Name:JEFFRIES-FERNANDEZ, TIFFANY LOGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LOGAN
Last Name:JEFFRIES-FERNANDEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 BRICKHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6859
Mailing Address - Country:US
Mailing Address - Phone:757-227-4100
Mailing Address - Fax:
Practice Address - Street 1:3074 BRICKHOUSE CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6859
Practice Address - Country:US
Practice Address - Phone:757-227-4100
Practice Address - Fax:757-963-9157
Is Sole Proprietor?:No
Enumeration Date:2009-05-24
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA104556510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor