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Individual

TIA M. EXLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3001 LYNDHURST AVE, WINSTON SALEM, NC 27103-4007
(336) 765-0383
Mailing address
2 OAK RIDGE DR, THOMASVILLE, NC 27360-3259
(336) 689-4749

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5009616
NC

Other

Enumeration date
06/26/2017
Last updated
06/26/2017
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