Provider Demographics
NPI:1114752177
Name:PERRY, TIFFANY MARIE (CD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 RIVERSTONE RD TRLR 8
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-2881
Mailing Address - Country:US
Mailing Address - Phone:505-716-2227
Mailing Address - Fax:
Practice Address - Street 1:3508 THAXTON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1629
Practice Address - Country:US
Practice Address - Phone:505-716-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula