Individual
TIFFANY PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1916 MELBROOK CT, MUNSTER, IN 46321-3235
(773) 848-1153
Mailing address
1916 MELBROOK CT, MUNSTER, IN 46321-3235
(773) 848-1153
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28168223A
IN
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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