| NPI | 1457810954 |
|---|---|
| Former Name | TIFFANY ANNETTE WHITEHEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 79681) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 116072) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2022-03-02 |