Individual
TIFFANY SUMMER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
BATTALION AVE., BLDG 33003, FORT HOOD, TX 76544
(254) 618-8782
Mailing address
5317 PEACENEST DR, RALEIGH, NC 27610-2189
(919) 771-8212
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
08/22/2023
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