Individual
TIARA AMBER PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(877) 498-4490
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN11001374
FL
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
5015182
NC
363LF0000X
Family Nurse Practitioner
APRN11001374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102546300
—
FL
05
—
1962964007
—
NC
Enumeration date
04/05/2019
Last updated
05/02/2023
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