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General NPI Number Information
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NPI Number | 1356230783
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Entity Type | Individual
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Provider Name | TIFFANY FUQUA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3690 GRANDVIEW PKWY
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3326
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Country | US
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Telephone | 205-971-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 160 MILLER DR
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City | PELL CITY
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State | AL
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Zip | 35125-4471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-166475
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License Number State | AL
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