Individual
TIFFANY DENISE CHURCHWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
601 BROAD ST STE 3148, AUGUSTA, GA 30901-1467
(762) 383-8350
Mailing address
601 BROAD ST STE 3148, AUGUSTA, GA 30901-1467
(762) 383-8350
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0000037316
GA
Other
Enumeration date
02/28/2019
Last updated
02/17/2021
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