Individual
TIFFANY MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
325 E. SILVER SPRING DRIVE, WHITEFISH BAY, WI 53217-5222
(414) 247-4800
(414) 247-4801
Mailing address
3003 W. GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47814
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00784994
RR MEDICARE
WI
Enumeration date
08/23/2006
Last updated
01/18/2011
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