Individual
TIFFANY MERRILL KETZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN ANP-C
Contact information
Practice address
6513 PRESTON RD, SUITE 300, PLANO, TX 75024-2688
(972) 608-2025
(972) 608-2032
Mailing address
3901 W 15TH ST, PLANO, TX 75075-7738
(972) 867-0129
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP111326
TX
363LA2200X
Adult Health Nurse Practitioner
681853
TX
Other
Enumeration date
08/20/2006
Last updated
01/04/2022
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