Provider Demographics
NPI:1629448337
Name:MICHAUX, TIFFANY NICOLE (ARNP)
Entity type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:NICOLE
Last Name:MICHAUX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5200 BABCOCK ST NE STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4639
Mailing Address - Country:US
Mailing Address - Phone:407-716-8528
Mailing Address - Fax:407-716-8528
Practice Address - Street 1:5200 BABCOCK ST NE STE 101
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4639
Practice Address - Country:US
Practice Address - Phone:407-716-8528
Practice Address - Fax:407-716-8528
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9247370363LG0600X
FLARNP9247370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology