Most Relevant Information
Provider Data
| NPI Number: | 1003369109 |
| Provider Name: | TIFFINIE WILSON FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 21607 |
Most Important Dates
| Enumeration Date: | 07/26/2016 |
| Last Updated: | 07/26/2016 |
Provider Practice Location
360 E EH CRUMP BLVD
MEMPHIS
TN
381265310
Practice Location Phone/Fax
| Phone: | 9012612000 |
| Fax: |
Provider Mailing Location
360 E EH CRUMP BLVD
MEMPHIS
TN
381265310
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |