| NPI | 1467963637 |
|---|---|
| Former Name | TIFFANY DAWN MANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA LP61315919) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201610057LPN) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2023-06-12 |