Individual
TIFFANY ANN ISAACS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 ASPEN DR, MANNFORD, OK 74044-7030
(191) 820-0154
Mailing address
109 ASPEN DR, MANNFORD, OK 74044-7030
(191) 820-0154
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
000000000
OK
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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