Healthcare Provider Details

I. General information

NPI: 1851116602
Provider Name (Legal Business Name): TIFFANY ANN SCHMITT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TIFFANY ANN BROWN

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S CARNEY
CARNEY OK
74832-9625
US

IV. Provider business mailing address

910639 S WASHINGTON ST
CHANDLER OK
74834-6652
US

V. Phone/Fax

Practice location:
  • Phone: 405-865-2344
  • Fax: 405-865-2345
Mailing address:
  • Phone: 405-760-6712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR0082941
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: