Individual
MS. TIFFANY DIANNE DINEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
251 UNIVERSITY BLVD, STE B, CONWAY, SC 29526-8834
(843) 347-1012
(843) 347-1218
Mailing address
300 SINGLETON RIDGE RD, ATTN PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
25803
SC
Other
Enumeration date
04/08/2022
Last updated
08/29/2024
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