Individual
TIFFANY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 SW 5TH ST # 3723, LAWTON, OK 73501-4649
(580) 558-8337
Mailing address
PO BOX 3723, LAWTON, OK 73502-3723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
215665
OK
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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