Healthcare Provider Details

I. General information

NPI: 1386280147
Provider Name (Legal Business Name): TIFFANEY HANIG RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 FOREST PL STE 200
LITTLE ROCK AR
72207-5287
US

IV. Provider business mailing address

190 AVIATION PLZ STE A-D
HOT SPRINGS AR
71913-5529
US

V. Phone/Fax

Practice location:
  • Phone: 501-566-1011
  • Fax:
Mailing address:
  • Phone: 501-525-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP-2249
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License NumberRCP-2249
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: