Individual
TIFFANY LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
6705 RANGEWOOD DR, COLORADO SPRINGS, CO 80918-7300
(719) 599-7331
Mailing address
4597 GOLD MEDAL PT APT 120, COLORADO SPRINGS, CO 80923-7372
(817) 925-8491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1660684
CO
367A00000X
Advanced Practice Midwife
Primary
APN.0997147-CNM
CO
Other
Enumeration date
02/08/2022
Last updated
03/27/2023
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