Tiffany Daugherty

Individual provider Active NPI Registered Nurse · Rocky Top, TN

NPI 1093584039 · NPPES record last updated Jan 1, 2024

Key facts

NPI
1093584039
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
245722 (TN)
Practice address
3026 Lake City Hwy
Rocky Top, TN 37769-5533
Phone
(865) 246-8941
NPI assigned
Jan 1, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
245722TNMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163W00000X 245722 TN Yes

Addresses

Primary practice location

3026 Lake City Hwy
Rocky Top, TN 37769-5533

Mailing address

3026 Lake City Hwy
Rocky Top, TN 37769-5533
Phone (865) 246-8941

Other providers in Rocky Top, TN

All providers in Rocky Top, TN · Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.