Individual
TIFFANY NICOLE BERBER-STANISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Mailing address
6602 W 127TH PL, CEDAR LAKE, IN 46303-7124
(219) 484-8941
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28162734A
IN
363L00000X
Nurse Practitioner
Primary
71007428A
IN
363LF0000X
Family Nurse Practitioner
71007428A
IN
Other
Enumeration date
07/28/2017
Last updated
12/13/2017
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