Individual
MS. TIFFANY GARRIS WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9228 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9125
(843) 574-5693
(843) 764-4512
Mailing address
9228 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9125
(843) 574-5693
(843) 764-4512
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18412
SC
363LF0000X
Family Nurse Practitioner
18412
SC
Other
Enumeration date
07/30/2013
Last updated
01/18/2022
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