Individual
TIFFANY LEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2209 JEFFERSON DAVIS DR, OXFORD, MS 38655-5221
(662) 281-1115
(662) 281-1113
Mailing address
1300 ACCESS RD STE 400, OXFORD, MS 38655-5211
(662) 281-1115
(662) 281-1113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R871899
MS
363LF0000X
Family Nurse Practitioner
Primary
871899
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02876000
—
MS
Enumeration date
09/22/2009
Last updated
04/14/2020
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