Individual
TIFFANY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
62 W HARVEY ST, PHILA, PA 19144-2720
(267) 438-4191
Mailing address
62 W HARVEY ST, PHILA, PA 19144-2720
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP49859500
NJ
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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