Individual
TIFFANY DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9929 DOWDEN RD UNIT 19113, ORLANDO, FL 32832-5062
(757) 710-1716
Mailing address
9929 DOWDEN RD UNIT 19113, ORLANDO, FL 32832-5062
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001294360
VA
Other
Enumeration date
12/26/2020
Last updated
12/26/2020
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