Individual
TIFFANY NICOLE PRATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9316 DEER PATH LN, KERNERSVILLE, NC 27284-8204
(502) 316-3279
Mailing address
9316 DEER PATH LN, KERNERSVILLE, NC 27284-8204
(502) 316-3279
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1131690
KY
163WM0102X
Maternal Newborn Registered Nurse
104561320
KY
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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