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NPI Code Detail

MEDICARE: TIFFANEE ANN PADGETT ARNP

MEDICARE: TIFFANEE ANN PADGETT ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP3201862FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24091JOTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558307421
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANEE ANN PADGETT ARNP
Provider Business Mailing Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-223-5400
Fax Number : 850-223-5401
Provider Business Practice Location Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-584-0600
Fax Number : 850-584-0602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 01/15/2014

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Directions to “ TIFFANEE ANN PADGETT ARNP” Practice Location

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