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Individual
MS. TIFFANY HORTON
Active
Individual
MS. TIFFANY HORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
103683
NC
363A00000X
Physician Assistant
Primary
103683
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103683
STATE LICENSE
NC
05
—
1144275165
—
NC
05
—
2640PA
—
SC
Enumeration date
05/24/2006
Last updated
11/15/2016
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