Individual
TIFFANY RAE SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20938 W BERKELEY RD, BUCKEYE, AZ 85396-2556
(623) 696-5029
Mailing address
20938 W BERKELEY RD, BUCKEYE, AZ 85396-2556
(623) 696-5029
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP052071
AZ
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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