Individual
TIFFANY HOMMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
24760 HOSPITAL DR, RED LAKE, MN 56671
(218) 679-3316
Mailing address
11795 E MOVIL LAKE RD NE, BEMIDJI, MN 56601-8116
(218) 444-6197
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 141209-5
MN
363LF0000X
Family Nurse Practitioner
Primary
0382922-22
MN
Other
Enumeration date
08/01/2006
Last updated
08/11/2015
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