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General NPI Number Information
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NPI Number | 1700637840
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Entity Type | Individual
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Provider Name | TIFFANY WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 2375-2475 JONES BLVD ONES BLVDC3
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City | LAS VEGAS
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State | NV
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Zip | 89151-0001
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Country | US
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Telephone | 702-214-2165
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Fax |
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Provider Business Mailing Address
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Address Line | 356 BLUE BAYOU CIR
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City | HENDERSON
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State | NV
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Zip | 89015-5312
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Country | US
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Telephone | 702-717-7148
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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