| NPI | 1982902888 |
|---|---|
| Former Name | TIFFANY DAWN REAGOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 652703) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2019-11-22 |