| NPI | 1477988095 |
|---|---|
| Former Name | TIFFANY NICHOLE RUSSAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NV APRN001581) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN75931) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2019-08-07 |