Provider Demographics
NPI:1780047845
Name:BAYES, TIFFANY (FNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BAYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 PARK AVE STE 626B
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5221
Mailing Address - Country:US
Mailing Address - Phone:901-767-4799
Mailing Address - Fax:901-767-4058
Practice Address - Street 1:6005 PARK AVE STE 626B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5221
Practice Address - Country:US
Practice Address - Phone:901-767-4799
Practice Address - Fax:901-767-4058
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN21091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily