Individual
TIFFANY PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456
(606) 256-2195
Mailing address
PO BOX 1310, MOUNT VERNON, KY 40456-1310
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3003382
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3003382
NURSE ANESTHETISTS
KY
Enumeration date
10/25/2006
Last updated
06/21/2018
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