TIFFANY NICOLE PUCKETT APRN NPI 1073073896

NPI Information

NPI: 1073073896
Provider Name: TIFFANY NICOLE PUCKETT, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SPARTANBURG MEDICAL CENTER

PECOS Registration: Yes

Address:
1053 CENTER STREET
WEST COLUMBIA, SC
ZIP 29169
Phone: (800) 491-0909
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Tiffany Nicole Puckett, APRN is a family nurse practitioner in West Columbia, SC with 11 years of experience. Tiffany Nicole Puckett, APRN NPI is 1073073896. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:2013

The provider's business location address is:

1053 CENTER STREET
WEST COLUMBIA, SC
ZIP 29169
Phone: (800) 491-0909

The NPI 1073073896 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2019 and was last updated on 4/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		22704	SOUTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family	22704	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP5810	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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