Healthcare Provider Details

I. General information

NPI: 1568390680
Provider Name (Legal Business Name): TIFFANY DENISE TAYLOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3512 SW 127TH ST
OKLAHOMA CITY OK
73170
US

IV. Provider business mailing address

3512 SW 127TH ST
OKLAHOMA CITY OK
73170
US

V. Phone/Fax

Practice location:
  • Phone: 918-861-6653
  • Fax:
Mailing address:
  • Phone: 918-861-6653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number228669
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: