| NPI | 1831948611 |
|---|---|
| Former Name | TIFFANY MARIE FARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191399) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: VA 0001238396) |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-10-10 |