NPI | 1255763488 |
---|---|
Former Name | TIFFANY K GARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18412) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18412) |
Enumeration Date | 2013-07-30 |
Last Update Date | 2022-01-18 |