Healthcare Provider Details

I. General information

NPI: 1467171447
Provider Name (Legal Business Name): TIFFANEY LARD CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7191 CAHABA VALLEY RD STE 207
HOOVER AL
35242-6443
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-980-2091
  • Fax:
Mailing address:
  • Phone: 205-980-2091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0622077
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-106774
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: