Provider Demographics
NPI:1952875361
Name:MEADOWS, TIFFANY D (CERT MEDICAL ASSIST)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:D
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:CERT MEDICAL ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-6622
Mailing Address - Country:US
Mailing Address - Phone:478-234-1513
Mailing Address - Fax:
Practice Address - Street 1:186 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-6622
Practice Address - Country:US
Practice Address - Phone:478-733-0651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant