Provider Demographics
NPI:1871090100
Name:MURRELL, TIFFANY J (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:J
Last Name:MURRELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-996-8478
Mailing Address - Fax:
Practice Address - Street 1:440 SCOTT ROLEN DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-2700
Practice Address - Country:US
Practice Address - Phone:812-996-5781
Practice Address - Fax:812-996-0150
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007916A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily