Individual
TIFFANY M COLAVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-2288
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0024180120
VA
208600000X
Surgery Physician
0024180120
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024180120
VA
364SA2100X
Acute Care Clinical Nurse Specialist
0024180120
VA
Other
Enumeration date
11/18/2020
Last updated
07/21/2025
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