Individual
MS. TIFFANY NANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2336 WISTERIA DR STE 440, SNELLVILLE, GA 30078-6160
(770) 743-1469
Mailing address
2336 WISTERIA DR STE 440, SNELLVILLE, GA 30078-6160
(770) 733-1469
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
BLUE CROSS
GA
01
—
101Y00000X
BLUE CROSS
—
Enumeration date
07/19/2020
Last updated
07/19/2020
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