| NPI | 1326841255 |
|---|---|
| Former Name | TIFFANY GINGER SULLENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: ID 1261172) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: OR 201903714NP-PP) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: HI APRN-4067-0) | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-05-02 |