Individual
TIFFANY ANNE LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 632-3420
Mailing address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 632-3420
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN2317473
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
231747
MA
Other
Enumeration date
08/19/2019
Last updated
07/08/2024
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