Individual
TIFFINI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9894 E 121ST ST, FISHERS, IN 46037
(317) 621-6060
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71008212A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017248
—
IN
Enumeration date
06/20/2018
Last updated
06/22/2021
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