| NPI | 1053169219 |
|---|---|
| Former Name | TIFFANY DARLENE WATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 305685) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN209925) |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |