Provider Demographics
NPI:1952564353
Name:TERRILL, TIFFANY A (APN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:TERRILL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 N JACKSON ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-8254
Mailing Address - Country:US
Mailing Address - Phone:931-461-1101
Mailing Address - Fax:931-461-1283
Practice Address - Street 1:1940 N JACKSON ST
Practice Address - Street 2:SUITE 150
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-8254
Practice Address - Country:US
Practice Address - Phone:931-461-1101
Practice Address - Fax:931-461-1283
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013162363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology