Individual
MS. TIFFANY MIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
640 MARTIN LUTHER KING JR BLVD STE 200, MACON, GA 31201-3297
(478) 334-1220
Mailing address
640 MARTIN LUTHER KING JR BLVD STE 200, MACON, GA 31201-3297
(478) 745-5455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN146927
GA
363LG0600X
Gerontology Nurse Practitioner
RN146927
GA
Other
Enumeration date
11/05/2024
Last updated
02/19/2026
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