Provider Demographics
NPI:1871884403
Name:ELLIOTT, TIFFANY N
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:
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 2234
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-2234
Mailing Address - Country:US
Mailing Address - Phone:828-349-9500
Mailing Address - Fax:828-349-9501
Practice Address - Street 1:154 HOUSTON GAP RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-4034
Practice Address - Country:US
Practice Address - Phone:828-349-9500
Practice Address - Fax:828-349-9501
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4347376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No376J00000XNursing Service Related ProvidersHomemaker