Individual
TIFFANY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27010 CARLYSLE ST, INKSTER, MI 48141-2554
(313) 817-7568
Mailing address
27010 CARLYSLE ST, INKSTER, MI 48141-2554
(313) 817-7568
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704402722
MI
164W00000X
Licensed Practical Nurse
4703104422
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704402722
MI
Other
Enumeration date
04/20/2015
Last updated
04/24/2025
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