Individual
TIFFANY RENE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
7217 CAMERON PARK DR, FORT SMITH, AR 72903-6167
(479) 831-6007
Mailing address
3500 S 70TH ST, FORT SMITH, AR 72903-5197
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
214718
AR
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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