Provider Demographics
NPI:1649318551
Name:WILEY-COX, TIFFANY NICOLE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:NICOLE
Last Name:WILEY-COX
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37345-3107
Mailing Address - Country:US
Mailing Address - Phone:931-636-0570
Mailing Address - Fax:
Practice Address - Street 1:1840 DECHERD BLVD
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324-3655
Practice Address - Country:US
Practice Address - Phone:931-967-1218
Practice Address - Fax:931-968-9479
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist