Individual
TIAH RAE YORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-4370
(601) 389-4372
Mailing address
121 TIAK CHITTO DR, PHILADELPHIA, MS 39350-4068
(601) 650-6281
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
879903
MS
363LF0000X
Family Nurse Practitioner
Primary
F02190023
MS
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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