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Individual

TIFFANY MAGALLANES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CPNP

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
0991941
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
95004127
CA

Other

Enumeration date
10/16/2015
Last updated
08/24/2016
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