Provider Demographics
NPI:1942667449
Name:CLOWERS, TIFFANY ANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ANNE
Last Name:CLOWERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLADENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28320-8439
Mailing Address - Country:US
Mailing Address - Phone:910-809-0030
Mailing Address - Fax:
Practice Address - Street 1:125 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLADENBORO
Practice Address - State:NC
Practice Address - Zip Code:28320-8439
Practice Address - Country:US
Practice Address - Phone:910-809-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06131363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical