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Individual
MS. TIFFANY MARIE WALTON
Active
Individual
MS. TIFFANY MARIE WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
22685068
NY
163WP0200X
Pediatric Registered Nurse
22685068
NY
164W00000X
Licensed Practical Nurse
Primary
10304898
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03810262
—
NY
Enumeration date
03/13/2014
Last updated
06/06/2015
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