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General NPI Number Information
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NPI Number | 1013652270
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Entity Type | Individual
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Provider Name | TIFFANY MARIE DE LEON RN
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 1001 NW 9TH ST
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City | TULIA
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State | TX
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Zip | 79088-1021
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Country | US
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Telephone | 806-654-2399
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 NW 9TH ST
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City | TULIA
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State | TX
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Zip | 79088-1021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 1042122
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License Number State | TX
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