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General NPI Number Information
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NPI Number | 1104754373
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Entity Type | Individual
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Provider Name | TIFFANY MICHELLE ANGEL RN
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Gender | Female
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Dates
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Enumeration Date | 05/09/2026
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Last Update Date | 05/09/2026
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Provider Practice Location Address
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Address Line | 1811 CHARLTON CT
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City | GOSHEN
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State | IN
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Zip | 46526-6464
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Country | US
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Telephone | 573-534-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 67732 STATE ROAD 15
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City | NEW PARIS
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State | IN
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Zip | 46553-9110
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28157712A
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License Number State | IN
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