Provider Demographics
NPI:1194336495
Name:WESTLIE, TIFFANIE (FMCHC)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:WESTLIE
Suffix:
Gender:F
Credentials:FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:SILVERADO
Mailing Address - State:CA
Mailing Address - Zip Code:92676-0123
Mailing Address - Country:US
Mailing Address - Phone:949-484-9296
Mailing Address - Fax:
Practice Address - Street 1:4986 SUMMIT CIR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-5780
Practice Address - Country:US
Practice Address - Phone:949-484-9296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator