Individual
MS. MARILYN ANN TIFFAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
105 N MAGNOLIA ST, SUMTER, SC 29150-4941
(803) 773-5511
Mailing address
1022 SKARDON ST, SUMTER, SC 29154-6072
(803) 481-3864
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
808
SC
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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