Individual
TIFFANY CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2404 SOFT MAPLE ST, ATLANTA, GA 30360-6600
(678) 650-0888
Mailing address
2404 SOFT MAPLE ST, ATLANTA, GA 30360-6600
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN252051
GA
Other
Enumeration date
03/21/2021
Last updated
03/21/2021
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