Individual provider · Type 1 NPI

Tiffany Brandice Wallace

Case Management Registered Nurse · Southfield, MI

NPI number 1972463222 Active

Practice location

29699 Southfield Rd
Southfield, MI 48076-2038

Specialties and licenses

TaxonomyCodeLicense
Case Management Registered Nurse Primary 163WC0400X4704424595 (MI)

Case Management Registered Nurse: Definition to come...

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About NPI 1972463222

Tiffany Brandice Wallace's National Provider Identifier is 1972463222, issued on Nov 17, 2025. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in Southfield, MI. The record was last updated on Jan 5, 2026.