Gary, Tishana L

Gary, Tishana L is an individual health care provider with primary practice located at 111A Berry Ave , Greer SC 29651-1307. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gary, Tishana L can be contacted via phone (864) 801-2035.

Contact Information

Primary practice address
111A Berry Ave Greer SC 29651-1307
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3284 South Carolina

Profile Details

NPI number 1275781775
LBN Legal business name Gary, Tishana L
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2008
Last updated Jan 10th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275781775 NPPES
South Carolina Other 3284 LICENSE

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