Individual
TIFFANY GAYLE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
517 FIFTH AVE, PICAYUNE, MS 39466-3203
(601) 799-5865
Mailing address
517 FIFTH AVE, PICAYUNE, MS 39466-3203
(504) 619-9733
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
234680
LA
363LP2300X
Primary Care Nurse Practitioner
Primary
906493
MS
Other
Enumeration date
03/13/2024
Last updated
03/14/2024
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