Provider Demographics
NPI:1477965705
Name:SEGUIN, TIFFANY ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ANN
Last Name:SEGUIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 HALL ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2288
Mailing Address - Country:US
Mailing Address - Phone:231-933-4926
Mailing Address - Fax:231-995-7900
Practice Address - Street 1:105 HALL ST
Practice Address - Street 2:SUITE D
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2288
Practice Address - Country:US
Practice Address - Phone:231-933-4926
Practice Address - Fax:231-995-7900
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704299541163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management