MEDICARE: TIFFANY NEWELL NP

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
1	363LF0000X	Family Nurse Practitioner	NEWE-FUNLNT	MS

General Provider Information

NPI Number	:	1538774310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY NEWELL NP

Provider Business Mailing Address
First Line	:	633 N STATE ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39202-3306
Country	:	US
Telephone Number	:	601-351-9889
Fax Number	:	601-351-9880

Provider Business Practice Location Address
First Line	:	633 N STATE ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39202-3306
Country	:	US
Telephone Number	:	601-351-9889
Fax Number	:	601-351-9880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	05/26/2026

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Directions to “ TIFFANY NEWELL NP” Practice Location

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