Healthcare Provider Details

I. General information

NPI: 1063033108
Provider Name (Legal Business Name): TIFFANY REFFIT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180B DEBUYS RD STE 103
BILOXI MS
39531-4423
US

IV. Provider business mailing address

180B DEBUYS RD STE 103
BILOXI MS
39531-4423
US

V. Phone/Fax

Practice location:
  • Phone: 228-806-7030
  • Fax: 877-796-0186
Mailing address:
  • Phone: 228-806-7030
  • Fax: 877-796-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number903878
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number903878
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: