Individual
TIFFANY MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2360 E PERSHING BLVD BLDG 7, CHEYENNE, WY 82001-5356
(307) 778-7550
Mailing address
2360 E PERSHING BLVD BLDG 7, CHEYENNE, WY 82001-5356
(307) 778-7550
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
23667
WY
Other
Enumeration date
08/23/2024
Last updated
08/27/2024
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