Healthcare Provider Details

I. General information

NPI: 1902685522
Provider Name (Legal Business Name): TIFFANY KELLEY MORFORD APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 09/22/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 S 3RD ST
MONTROSE CO
81401-4209
US

IV. Provider business mailing address

8171 HATCHERY RD
HOTCHKISS CO
81419-9241
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-6737
  • Fax:
Mailing address:
  • Phone: 970-361-7106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0998950
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: