Individual
TIFFANY J GRAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1000 10TH AVE, ACKLEY, IA 50601-1701
(641) 847-2625
(641) 847-2509
Mailing address
802 KENYON RD STE A, FORT DODGE, IA 50501-5740
(515) 574-8484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A115619
IA
363LF0000X
Family Nurse Practitioner
A115819
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124396387
TRIMARK PHYSICIANS GROUP NPI
IA
Enumeration date
01/27/2016
Last updated
10/14/2020
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