Individual
TIFFANY D LANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 598-6127
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
63861
WV
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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