Individual
TIFFANY K FLAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
25 PROSPECT CIR, TROY, MO 63379-3173
(636) 528-2650
(636) 528-2661
Mailing address
1551 WALL ST, SUITE 310, SAINT CHARLES, MO 63303-3539
(636) 669-2268
(314) 209-8127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2012016458
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012016458
LICENSE
MO
Enumeration date
06/27/2012
Last updated
06/27/2012
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