Provider Demographics
NPI:1548485436
Name:CALDWELL, TIFFANY REIGHARD (RN, CNOR,RNFA)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:REIGHARD
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN, CNOR,RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 NEWNAN RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30116-6430
Mailing Address - Country:US
Mailing Address - Phone:770-265-9436
Mailing Address - Fax:770-834-3883
Practice Address - Street 1:1646 NEWNAN RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30116-6430
Practice Address - Country:US
Practice Address - Phone:770-265-9436
Practice Address - Fax:770-834-3883
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN126668163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant