Healthcare Provider Details

I. General information

NPI: 1316233067
Provider Name (Legal Business Name): TIFFANY NICOLE ANDRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 LAKESHORE DR
BIRMINGHAM AL
35209-8803
US

IV. Provider business mailing address

2200 LAKESHORE DR
BIRMINGHAM AL
35209-8803
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-6926
  • Fax: 205-868-6673
Mailing address:
  • Phone: 205-871-6926
  • Fax: 205-868-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35096
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: