Healthcare Provider Details

I. General information

NPI: 1861883639
Provider Name (Legal Business Name): TIFFANI ANN WATSON MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TIFFANI ANN ARTHUR

II. Dates (important events)

Enumeration Date: 02/14/2015
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 22ND AVE E
SPRINGFIELD TN
37172-3754
US

IV. Provider business mailing address

2004 HAYES ST STE 800
NASHVILLE TN
37203-2659
US

V. Phone/Fax

Practice location:
  • Phone: 615-384-5558
  • Fax:
Mailing address:
  • Phone: 615-329-0570
  • Fax: 615-329-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number170494
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number19416
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: