Provider Demographics
NPI:1700172558
Name:LOCKE, TIFFANY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:LOCKE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:HAYDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 440100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0100
Mailing Address - Country:US
Mailing Address - Phone:615-848-0488
Mailing Address - Fax:615-904-9061
Practice Address - Street 1:1840 MEDICAL CENTER PKWY
Practice Address - Street 2:STE 300
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2564
Practice Address - Country:US
Practice Address - Phone:615-848-0488
Practice Address - Fax:615-904-9061
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN15742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner