Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 0533912 | KS |
Y | 2080P0205X | Pediatric Endocrinologist | 2009010058 | MO |
NPI | 1104044874 |
---|---|
Provider Name | Tiffany Sue Musick |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 17/06/2011 |