Provider Demographics
NPI:1649970054
Name:HAVARD, TIFFANY RENAE (APRN, WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:RENAE
Last Name:HAVARD
Suffix:
Gender:F
Credentials:APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 COIT RD APT 18104
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-5840
Mailing Address - Country:US
Mailing Address - Phone:469-833-0405
Mailing Address - Fax:
Practice Address - Street 1:440 COIT RD APT 18104
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5840
Practice Address - Country:US
Practice Address - Phone:469-833-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179557363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health