Individual
TIFFANY DENISE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
733 SW CR 242-A, LAKE CITY, FL 32025
(386) 292-1994
Mailing address
733 SW CR 242-A, LAKE CITY, FL 32025
(386) 292-1994
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
170312
FL
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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