Individual
TIFFANY L LASERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 934-9999
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
GAA-NP000597
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
1-171693
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003271688A
—
GA
01
—
G33061A
MEDICARE
GA
Enumeration date
04/07/2020
Last updated
02/01/2024
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