Doctor Name: | KRISTINA TIFFANY MCMAHON |
NPI Number: | 1053600171 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNP-C |
License Number: | 372279-4405 |
Business Practice Address: | 1173 S 250 W Suite 101 St George, UT - 847706392 |
Business Phone Number: | 4356190519 |
Business Fax Number: | |
Mailing Address: | 30 E 200 N, LA VERKIN |
State: | UT |
Postal Code: | 847455304 |
Phone Number: | 4356190519 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2011 |
NPI Last Update Date: | 03/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 372279-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |