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Individual

TIERRA IZZARD-JEFFERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
113 EXECUTIVE POINTE BLVD STE 104, COLUMBIA, SC 29210-8681
(803) 573-9453
Mailing address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
27313
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
27313
SC

Other

Enumeration date
05/02/2023
Last updated
09/25/2025
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