Individual
TIFFIANY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
163 COUNTY ROAD 1856, CHICO, TX 76431-3429
(940) 389-3884
Mailing address
163 COUNTY ROAD 1856, CHICO, TX 76431-3429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
11277056-3101
UT
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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