Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APN.0992903-NP | CO |
NPI | 1033657218 |
---|---|
Provider Name | Tiffany Marie Balin |
First Address | Nashville, TN 37203-2926 |
Second Address | Highlands Ranch, CO 80129-2440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2017 |
Last Update Date | 29/10/2019 |