Individual
MISS TIFFANY KRISTINE GOUGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
56-660 KAMEHAMEHA HWY, KAHUKU, HI 96731-2210
(808) 293-7555
Mailing address
1655 KEWALO ST APT E, HONOLULU, HI 96822-3124
(413) 695-5157
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
84703
HI
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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