Provider Demographics
NPI:1861073785
Name:EDDINS, TIFFANY
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:EDDINS
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 1:8295 TOURNAMENT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8900
Mailing Address - Country:US
Mailing Address - Phone:423-704-2383
Mailing Address - Fax:
Practice Address - Street 1:8295 TOURNAMENT DR STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8900
Practice Address - Country:US
Practice Address - Phone:423-704-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
TNI000000028665374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health Aide