Individual
TIFFANY RENEE CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6100 WHIRLAWAY RD, GRANITEVILLE, SC 29829-3967
(803) 293-8969
Mailing address
6100 WHIRLAWAY RD, GRANITEVILLE, SC 29829-3967
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN238298
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
NA
—
Enumeration date
01/04/2021
Last updated
01/04/2021
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