Individual
TYHENA WEATHERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
180 SOUTHWOOD DR, CLINTON, NC 28328-5002
(910) 592-8165
Mailing address
3737 ALSON RD APT 203, FAYETTEVILLE, NC 28314-0054
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5023707
NC
Other
Enumeration date
12/29/2025
Last updated
12/31/2025
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