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Individual

TIFFANY G MCKEEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3900
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GP1551
MEDICAID GROUP #
SC
05
NP1428
SC
01
P00883445
MEDICARE RAILROAD
SC
Enumeration date
04/28/2009
Last updated
11/04/2022
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