Individual
TIFFANY MIELING BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2790 RODEO RD APT 222, ABBEVILLE, LA 70510-4082
(850) 405-6036
(850) 405-6036
Mailing address
2790 RODEO RD APT 222, ABBEVILLE, LA 70510-4082
(850) 405-6036
(850) 405-6036
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN240501
LA
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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