Individual
TIFFANY J WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, APNP
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5020
Mailing address
4211 W AVENIDA DEL REY, PHOENIX, AZ 85083-2400
(920) 252-2630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
125313-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076470
CCNA
WI
Enumeration date
01/24/2007
Last updated
04/30/2015
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