Individual
MRS. DEIDRE COBB TIFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
210 GARDEN CIR, HINESVILLE, GA 31313-4421
(912) 977-4643
(912) 369-6530
Mailing address
210 GARDEN CIR, HINESVILLE, GA 31313-4421
(912) 977-4643
(912) 369-6530
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
MSW003123
GA
163W00000X
Registered Nurse
RN081939
GA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN081939
GA
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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