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1023740313
SUSANNA TIFFANY PRUANGKARN
NELLIS AFB, NV
NPI
1023740313
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: NY F432303-01)
Enumeration Date
2022-06-27
Last Update Date
2023-08-08
Business Address
SUSANNA TIFFANY PRUANGKARN AGACNP
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191-6600
Phone number: 702-653-2273
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Mailing Address
SUSANNA TIFFANY PRUANGKARN AGACNP
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191-6600
Phone number: 702-653-3560
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