| NPI | 1386194769 |
|---|---|
| Former Name | TIFFANY CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174099) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001221474) |
| 163W00000X Registered Nurse (Licence: FL 9296965) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9296965) | |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2024-08-29 |