Basic Information
| Provider Information | |||||||||
| NPI: | 1467821272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOGGANS | ||||||||
| FirstName: | TIFFANY | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 INDEPENDENCE PT | ||||||||
| Address2: | STE 212 | ||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296154536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8647976015 | ||||||||
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| Practice Location | |||||||||
| Address1: | 106 PARKVIEW DR | ||||||||
| Address2: | |||||||||
| City: | LAURENS | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293602652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649840571 | ||||||||
| FaxNumber: | 8649843610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2015 | ||||||||
| LastUpdateDate: | 01/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 19658 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.