NPI | 1396394227 |
---|---|
Former Name | TIFFANY LYNN POE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11004335) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9360004) |
Enumeration Date | 2019-09-04 |
Last Update Date | 2025-06-24 |