Individual
TIFFANY HERMAN DIESO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
40 MEDICINE CIR, DURHAM, NC 27710-0001
(919) 385-7941
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4855
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
246947
NC
Other
Enumeration date
10/30/2015
Last updated
04/06/2021
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