Individual
TIFFANY S TATE-COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7928 N 154TH AVE, BENNINGTON, NE 68007-1820
(402) 332-8193
Mailing address
7928 N 154TH AVE, BENNINGTON, NE 68007-1820
(402) 332-8193
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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