Individual
TIFFANY HIDDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
989 W MAIN ST, WAUPUN, WI 53963-1600
(920) 296-2222
Mailing address
989 W MAIN ST, WAUPUN, WI 53963-1600
(920) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314087-31
WI
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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