| NPI | 1972842847 |
|---|---|
| Former Name | TIFFANY E LYON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP016294) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC APRN18148) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 18148) | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2020-05-11 |