Healthcare Provider Details

I. General information

NPI: 1932659414
Provider Name (Legal Business Name): TIFFANY LEE GARNER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. TIFFANY LEE GUERRIERI

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 09/20/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22347 NORTHWESTERN PIKE
ROMNEY WV
26757-6343
US

IV. Provider business mailing address

PO BOX 97
BAKER WV
26801-0097
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-3838
  • Fax:
Mailing address:
  • Phone: 304-897-5915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9279936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: