NPI | 1053392373 |
---|---|
Former Name | TIFFANY D SHELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP030802) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R137035) |
363LF0000X Nurse Practitioner, Family (Licence: MD R137035) | |
Enumeration Date | 2005-11-14 |
Last Update Date | 2024-12-05 |