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Individual

MISS TIFFANI D. SHOWALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3883 74TH AVENUE NE, FORT TOTTEN, ND 58335
(701) 766-1600
Mailing address
PO BOX 309, FORT TOTTEN, ND 58335-0309
(701) 766-1600

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
964
AK
363AM0700X
Medical Physician Assistant
PA06531
TX

Other

Enumeration date
06/17/2010
Last updated
10/18/2013
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