Individual
TIFFANY HOSP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
739 N JEFFERSON ST STE 200, MASCOUTAH, IL 62258-1447
(618) 566-8810
(618) 566-7121
Mailing address
739 N JEFFERSON ST STE 200, MASCOUTAH, IL 62258-1447
(618) 566-8810
(618) 566-7121
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209027100
IL
Other
Enumeration date
04/12/2023
Last updated
02/04/2025
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