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General NPI Number Information
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NPI Number | 1972376234
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Entity Type | Organization
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Legal Business Name | TLC HEALTHCARE PROVIDERS LLC
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 105 VULCAN RD STE 221
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City | BIRMINGHAM
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State | AL
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Zip | 35209-4701
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Country | US
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Telephone | 205-378-8151
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Fax | 205-546-8519
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Provider Business Mailing Address
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Address Line | 105 VULCAN ROAD STE 221 PMB 1100
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City | BIRMINGHAM
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State | AL
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Zip | 35209
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Country | US
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Telephone | 205-729-4465
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Fax |
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Authorized Official
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Title or Position | FNP-BC
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Name | TIFFANEE MOORE
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Credential | MSN
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Telephone | 205-378-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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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 |
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License Number State |
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