NPI | 1073533782 |
---|---|
Former Name | TIFFANY WINGATE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R855554) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MS R855554) |
363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MS R855554) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MS R855554) | |
Enumeration Date | 2006-07-19 |
Last Update Date | 2023-10-04 |