Individual
TIFFANY M MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1000 E 24TH ST, KANSAS CITY, MO 64108-2776
(440) 339-4714
Mailing address
1000 E 24TH ST, KANSAS CITY, MO 64108-2776
(440) 339-4714
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2001601565
MO
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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