Healthcare Provider Details

I. General information

NPI: 1154806586
Provider Name (Legal Business Name): TIFFANY BILLIOT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY ROSE MORRELL

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15790 PAUL VEGA MD DR
HAMMOND LA
70403-1434
US

IV. Provider business mailing address

PO BOX 2668
HAMMOND LA
70404-2668
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-1369
  • Fax:
Mailing address:
  • Phone: 985-230-1683
  • Fax: 985-230-1617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10069
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: