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General NPI Number Information
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NPI Number | 1598202707
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Entity Type | Individual
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Provider Name | TIFFANY LONG HOWELL CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 704-384-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 327 WESTBEND DR
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City | CHARLOTTE
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State | NC
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Zip | 28262-2410
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Country | US
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Telephone | 336-250-5442
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 254304
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 113634
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License Number State | NC
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