Individual
TIFFANY LORRAINE WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3050 W AGUA FRIA FWY, PHOENIX, AZ 85027-3946
(602) 802-8388
Mailing address
3050 W AGUA FRIA FWY, PHOENIX, AZ 85027-3946
(602) 802-8388
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
933195
TX
363L00000X
Nurse Practitioner
1029194
TX
363L00000X
Nurse Practitioner
Primary
312637
AZ
363LF0000X
Family Nurse Practitioner
1029194
TX
Other
Enumeration date
08/03/2020
Last updated
06/06/2025
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