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1457823056
TIFFANY HICKS GARDNER
CARBONDALE, IL
NPI
1457823056
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: IL 209017781)
Enumeration Date
2018-12-19
Last Update Date
2018-12-19
Business Address
TIFFANY HICKS GARDNER APRN
1155 CEDAR CT
CARBONDALE, IL 62901-5333
Phone number: 618-490-1045
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Mailing Address
TIFFANY HICKS GARDNER APRN
PO BOX 423
CARRIER MILLS, IL 62917-0423
Phone number: 618-499-2307
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