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Individual
TIFFANY PERSONS
Active
Individual
TIFFANY PERSONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020023579
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020023579
MISSOURI LICENSE
MO
Enumeration date
07/31/2020
Last updated
07/31/2020
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