Individual
TIERRA DANIELLE CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5085 MORGANTON RD STE 100, FAYETTEVILLE, NC 28314-1497
(910) 613-4486
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5020567
NC
Other
Enumeration date
07/11/2024
Last updated
08/02/2024
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