Individual
TAMARA TILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1324 GROVE PARK DR, ORANGEBURG, SC 29115-2455
(803) 536-0007
Mailing address
196 BIG BUCK BLVD, ORANGEBURG, SC 29115-9516
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23808
SC
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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