Individual
TIFFANEY KRYSTAL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
743 W BROWN ST, MILWAUKEE, WI 53205-1304
(414) 517-9015
Mailing address
743 W BROWN ST, MILWAUKEE, WI 53205-1304
(414) 517-9015
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306948-31
WI
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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