Individual
TIFFANY D. DUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3200 MACCORKLE AVE SE, DEPT. OF SURGERY, CHARLESTON, WV 25304-1227
(304) 388-5503
(304) 388-9852
Mailing address
3200 MACCORKLE AVE SE, DEPT. OF SURGERY, CHARLESTON, WV 25304-1227
(304) 388-5503
(304) 388-9852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.16150
OH
367500000X
Certified Registered Nurse Anesthetist
APRN70833-CRNA
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106310
—
OH
Enumeration date
06/05/2014
Last updated
09/09/2021
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