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Individual

TIFFANY CLARKE LANCASTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.P.N.P.

Contact information

Practice address
10410 RIDGEFIELD PARKWAY, RICHMOND, VA 23233
(804) 754-3776
(804) 754-0880
Mailing address
10410 RIDGEFIELD PARKWAY, RICHMOND, VA 23233
(804) 754-3776
(804) 754-0880

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024166969
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010293979
VA PAREMIER KENB
VA
05
010293979
VA
01
010293987
VA PREMIER SOUTH HILL
VA
05
010293987
VA
05
010294011
VA
01
224189800
DOL
VA
Enumeration date
07/03/2006
Last updated
09/03/2013
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