Individual
MRS. TIFFANY JEANNE-MILLS WIMSATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201A LONGWOOD DR SE, HUNTSVILLE, AL 35801-2742
(850) 233-3376
(850) 522-8354
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(850) 233-3376
(850) 522-8354
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010-03282
NC
363AM0700X
Medical Physician Assistant
Primary
56953
CA
363AM0700X
Medical Physician Assistant
PA-1193
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NC9403A
MEDICARE PTAN
NC
Enumeration date
04/10/2012
Last updated
03/04/2026
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