Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001889 | NY |
NPI | 1124501580 |
---|---|
Provider Name | Tiffani Hughson |
First Address | Plattsburgh, NY 12901-2789 |
Second Address | Plattsburgh, NY 12901-2789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2018 |
Last Update Date | 15/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001889 | NYS LICENSE (01) | NY |