Individual
CHEYENNE WILSON TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
723 S VAN BUREN RD STE B, EDEN, NC 27288-5418
(336) 623-5171
Mailing address
723 S VAN BUREN RD STE B, EDEN, NC 27288-5418
(336) 613-1392
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001013693
NC
Other
Enumeration date
10/24/2023
Last updated
06/14/2024
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