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Individual

TIFFANY MONIQUE SAMUELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EMT-B/ HEALTHCARE SP

Contact information

Practice address
301 ANDREWS AVENUE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362
(334) 255-7894
(334) 255-7490
Mailing address
301 ANDREWS AVENUE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362
(334) 255-7894
(334) 255-7490

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
376K00000X
Nurse's Aide

Other

Enumeration date
03/25/2008
Last updated
03/25/2008
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