| Doctor Name: | TIFFANY WINGATE |
| NPI Number: | 1073533782 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NNP |
| License Number: | R855554 |
| Business Practice Address: | 5 River Bend Place Suite C Flowood, MS - 39232 |
| Business Phone Number: | 6019577345 |
| Business Fax Number: | 7692515429 |
| Mailing Address: | P O Box 320039, FLOWOOD |
| State: | MS |
| Postal Code: | 39232 |
| Phone Number: | 6019577345 |
| Fax Number: | 7692515924 |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 04/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0005X |
| License Number: | R855554 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal, Critical Care |
| Taxonomy Definition: | |