Individual
TIFFANY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3010 FARROW RD, COLUMBIA, SC 29203-7607
(803) 434-2650
(803) 434-5600
Mailing address
3010 FARROW RD, COLUMBIA, SC 29203-7607
(803) 434-2650
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
20102
SC
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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