| NPI | 1841931631 |
|---|---|
| Former Name | TIFFANY RENEE POTTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 79868) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 79868) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-02-08 |