Individual
TIFFANY CHRISTIANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
150 SHOUP AVE STE 17, IDAHO FALLS, ID 83402-3653
(208) 528-5892
(208) 528-5747
Mailing address
150 SHOUP AVE STE 17, IDAHO FALLS, ID 83402-3653
(208) 528-5892
(208) 528-5747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 623
ID
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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