Provider Demographics
NPI:1730939794
Name:RECKLING, TIFFANY DAWN (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:DAWN
Last Name:RECKLING
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:D
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:801 COTTAGE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5400
Practice Address - Country:US
Practice Address - Phone:501-686-8818
Practice Address - Fax:501-526-7217
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR227945363LP2300X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology