NPI | 1033574744 |
---|---|
Former Name | TIFFANY KUKLINSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 9322) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9322) |
Enumeration Date | 2015-12-22 |
Last Update Date | 2024-02-19 |