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NPI Code Detail

MEDICARE: TIFFANY WALTERS NCPRSS

MEDICARE: TIFFANY WALTERS NCPRSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1053083675
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY WALTERS NCPRSS
Provider Business Mailing Address
First Line : 125 COOL SPRINGS BLVD STE 270
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-6574
Country : US
Telephone Number : 888-339-9404
Fax Number :
Provider Business Practice Location Address
First Line : 710 E MAIN ST
Second Line :
City : LEXINGTON
State : KY
Zip : 40502-1668
Country : US
Telephone Number : 888-339-9404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2021
Last Update Date : 10/01/2021

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Directions to “ TIFFANY WALTERS NCPRSS” Practice Location

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