NPI | 1487191268 |
---|---|
Former Name | AMY CAROLYN TIFFANY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: OK 77876) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2020041080) |
Enumeration Date | 2017-01-31 |
Last Update Date | 2023-11-22 |