Individual
TIFFANY BUCHHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5726 TECUMSEH AVE, MONONA, WI 53716-2964
(608) 206-3223
(608) 242-6848
Mailing address
5726 TECUMSEH AVE, MONONA, WI 53716-2964
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1968-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42899000
—
WI
01
—
60737
DEAN HEALTH INSURANCE
WI
Enumeration date
11/10/2006
Last updated
10/08/2021
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