Individual
MRS. TIFFANY LASSETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
Mailing address
121 FOREST LANE, IDER, AL 35981
(256) 717-9680
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-175741
AL
Other
Enumeration date
02/21/2023
Last updated
12/05/2025
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