Individual
TIFFANY ASHLEA FANSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 HONEYSUCKLE DR, MATHIAS, WV 26812-8573
(304) 490-9674
Mailing address
200 HONEYSUCKLE DR, MATHIAS, WV 26812-8573
(304) 490-9674
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
66328
WV
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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