Individual
TIFFANY A NUNNELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6036 N 19TH AVE, 505, PHOENIX, AZ 85015
(602) 841-0721
(602) 841-0729
Mailing address
8620 N 22ND AVE, 200, PHOENIX, AZ 85021-4251
(602) 674-6506
(602) 674-6512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4788
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
438727
—
AZ
Enumeration date
06/24/2008
Last updated
12/16/2009
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