Basic Information
| Provider Information | |||||||||
| NPI: | 1205289469 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TIGLAO | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | APRN, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1940 HARRISON AVE | ||||||||
| Address2: | |||||||||
| City: | PANAMA CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 324054542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8507630017 | ||||||||
| FaxNumber: | 8506925862 | ||||||||
| Practice Location | |||||||||
| Address1: | 1940 HARRISON AVE | ||||||||
| Address2: | |||||||||
| City: | PANAMA CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 324054542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8507630017 | ||||||||
| FaxNumber: | 8506925862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2016 | ||||||||
| LastUpdateDate: | 01/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95024404 | CA | N | Nursing Service Providers | Registered Nurse | 163WP0808X | RN9376191 | FL | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | APRN11005752 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.