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General NPI Number Information
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NPI Number | 1376093443
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Entity Type | Individual
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Provider Name | TIFFANY RICHEY APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 910 NW 139TH STREET PKWY
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City | EDMOND
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State | OK
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Zip | 73013-9525
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Country | US
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Telephone | 405-254-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 10712 GREEN VALLEY RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73151-9488
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Country | US
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Telephone | 405-432-6789
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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 | 109072
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License Number State | OK
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