Individual
TIFFANY JAMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM, CFTS
Contact information
Practice address
1142 SHIPYARD BLVD, WILMINGTON, NC 28412-6439
(910) 350-0067
Mailing address
8 BALLARD DR, CASTLE HAYNE, NC 28429-5600
(910) 350-0067
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795101
—
NC
Enumeration date
03/09/2007
Last updated
07/08/2007
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