Healthcare Provider Details

I. General information

NPI: 1003733049
Provider Name (Legal Business Name): TIFFANY ANN BARTLETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 WRIGHT AVE # B2
ALMA MI
48801-1617
US

IV. Provider business mailing address

1240 E BROOMFIELD ST APT B2
MOUNT PLEASANT MI
48858-7189
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-4971
  • Fax: 989-463-6515
Mailing address:
  • Phone: 989-463-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: