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General NPI Number Information
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NPI Number | 1770077885
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Entity Type | Individual
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Provider Name | TIFFANY SPARKS CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 5104 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0237
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Country | US
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Telephone | 256-878-8180
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Fax | 256-891-3693
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Provider Business Mailing Address
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Address Line | 5104 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0237
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Country | US
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Telephone | 256-878-8180
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Fax | 256-891-3693
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-130505
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-130505
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License Number State | AL
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