Individual
TIFFANY DEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17544 SALLY AVE, GREENWELL SPRINGS, LA 70739-5430
(865) 773-8675
Mailing address
17544 SALLY AVE, GREENWELL SPRINGS, LA 70739-5430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30003029
LA
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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