Provider Demographics
NPI:1831476548
Name:GARRETT, TIFFANY J (CNP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:J
Last Name:GARRETT
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1882 RUSH CRK
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-5992
Mailing Address - Country:US
Mailing Address - Phone:575-496-2965
Mailing Address - Fax:
Practice Address - Street 1:3347 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-1760
Practice Address - Country:US
Practice Address - Phone:325-275-7866
Practice Address - Fax:505-367-0479
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042849363L00000X
NMCNP-01880363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner