Individual
TIFFANY LYNN DEERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1017 W 7TH ST, WRAY, CO 80758-1420
(970) 332-4895
(970) 332-4665
Mailing address
1017 W 7TH ST, WRAY, CO 80758-1420
(970) 332-4895
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2489
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51079852
—
CO
Enumeration date
11/05/2007
Last updated
11/17/2022
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