Individual
TIFFANY WILSON WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22394 MIFLIN RD STE 203, FOLEY, AL 36535-9593
(251) 943-3622
(251) 943-3683
Mailing address
22394 MIFLIN RD STE 203, FOLEY, AL 36535-9593
(251) 943-3622
(251) 943-3683
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-134555
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232206
—
AL
Enumeration date
03/11/2019
Last updated
11/13/2020
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