Individual
MRS. TIFFANY JANE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 NORTH 5TH STREET, BASIN, WY 82410
(307) 568-3700
(307) 586-2217
Mailing address
525 NORTH 5TH STREET, BASIN, WY 82410
(307) 568-3700
(307) 586-2217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1142
WY
Other
Enumeration date
10/08/2009
Last updated
05/21/2024
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