Individual
TIFFANY LYNNE BOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8560 COOK ST, MOUNT PLEASANT, NC 28124-7686
(704) 436-6521
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5000948
NC
Other
Enumeration date
10/07/2005
Last updated
07/15/2024
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