Individual
TIFFANY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12113 JESSICA CIR, GULFPORT, MS 39503-4198
(228) 261-6358
Mailing address
12113 JESSICA CIR, GULFPORT, MS 39503-4198
(228) 261-6358
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700470317
NPI
—
Enumeration date
03/05/2025
Last updated
03/05/2025
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