Provider Demographics
NPI:1811656325
Name:LANKFORD, TIFFANY LYNN (NDTR)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LYNN
Last Name:LANKFORD
Suffix:
Gender:F
Credentials:NDTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 ARIZONA CT
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-4293
Mailing Address - Country:US
Mailing Address - Phone:517-214-1657
Mailing Address - Fax:
Practice Address - Street 1:6204 ARIZONA CT
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058-4293
Practice Address - Country:US
Practice Address - Phone:517-214-1657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist