LAURA ROSALIE TIFFANY-HARROD


Address: 14636 Shave Lake Drive, Roanoke, TX 76262
Phone: 2604094905

LAURA ROSALIE TIFFANY-HARROD (NPI# 1952780496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952780496
Entity Type Individual
Full Name LAURA ROSALIE TIFFANY-HARROD
Credential CSFA, LSA
Practice Address 14636 Shave Lake Drive
Roanoke
TX 76262
Mailing Address Po Box 2165
Roanoke
TX 76262
Practice Telephone 2604094905
Practice Fax Number 4697022663
Mailing Telephone 2604094905
Mailing Fax Number 4697022663
Enumeration Date 2015-05-28
Last Update Date 2019-01-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 14636 SHAVE LAKE DRIVE
City ROANOKE
State TX
Zip Code 76262

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1770832388 Hillery Gabrielle Key Physician Assistant 13709 Ponderosa Ranch Rd, Roanoke, TX 76262-4535 2012-08-29
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1801304407 Tyler Bryce Kemp Physician Assistant 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 2018-01-17
1194231449 Chelsea Behetherland Greenspan Physician Assistant 2001 Crystal Spring Ave Sw Ste 201, Roanoke, VA 24014-2465 2017-12-22
1548708670 Mackenzie Meador Patterson Physician Assistant 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 2017-02-09
1013454776 Kathryn Conrad Hoyt Physician Assistant 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 2017-01-19
1578009775 Kathryn Lyon Tolmie Physician Assistant 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 2017-01-11
1518401272 Brian Buccola Physician Assistant 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2016-12-14
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Competitor

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City ROANOKE
Zip Code 76262

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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