Individual
TIFFANY A THIEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 FAYETTEVILLE ST, DURHAM, NC 27707-2325
(919) 956-4000
Mailing address
PO BOX 52119, DURHAM, NC 27717-2119
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
215128
NC
Other
Enumeration date
10/17/2012
Last updated
04/15/2013
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