Individual
TIFFANY A DORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
196454-30
WI
363L00000X
Nurse Practitioner
Primary
9853-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098282
—
WI
Enumeration date
01/31/2014
Last updated
12/01/2021
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