Individual
TIFANI BAISDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
48332 STAPLETON AVE, MACOMB, MI 48042-5193
(586) 260-8097
Mailing address
48332 STAPLETON AVE, MACOMB, MI 48042-5193
(586) 260-8097
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704305401
MI
Other
Enumeration date
11/16/2020
Last updated
05/14/2021
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