MEDICARE: MRS. TIFFANY HOPE SHEPHERD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LC1500X	Community Health Nurse Practitioner	5007642	NC
2	363LF0000X	Family Nurse Practitioner	APN.19719	SC
3	363L00000X	Nurse Practitioner	5007642	NC

General Provider Information

NPI Number	:	1255711297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY HOPE SHEPHERD

Provider Business Mailing Address
First Line	:	6507 NORTH KINGS HWY
Second Line	:	DR NORMAN'S MYRTLE BEACH DIET & REGENERATIVE CENTER
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572
Country	:	US
Telephone Number	:	843-692-9494
Fax Number	:	843-692-7474

Provider Business Practice Location Address
First Line	:	6507 NORTH KINGS HWY
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572
Country	:	US
Telephone Number	:	843-692-9494
Fax Number	:	843-692-7474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	10/30/2023

Similar Medicare Providers

1891448064 — ANGELIC HEALTH PRACTICE GROUP
Practice Location Address:

923C MEDICAL CIRCLE
MYRTLE BEACH, SC
29572

Practice Phone: 843-356-9078
Practice Fax: 843-356-4086

1962331405 — RYAN KING PMHNP
Practice Location Address:

630 CHESTNUT RD
MYRTLE BEACH, SC
29572-5502

Practice Phone: 843-945-1452
Practice Fax:

1457423196 — HANGER PROSTHETICS & ORTHOTICS INC
Practice Location Address:

931 MEDICAL CIR
MYRTLE BEACH, SC
29572-4122

Practice Phone: 843-712-1069
Practice Fax:

1649100942 — DR. DEOR ZOHAR
Practice Location Address:

8215 N KINGS HWY
MYRTLE BEACH, SC
29572-3062

Practice Phone: 843-597-8580
Practice Fax:

1245160134 — ELLIOTT TRISTAN RODGERS OTR/L
Practice Location Address:

1129 BOMBAY LN UNIT 8201
MYRTLE BEACH, SC
29572-4692

Practice Phone: 910-789-4532
Practice Fax:

1295374692 — MANDA RAE WETZEL FNP
Practice Location Address:

809 82ND PKWY
MYRTLE BEACH, SC
29572-4607

Practice Phone: 843-692-1000
Practice Fax:

Directions to “ MRS. TIFFANY HOPE SHEPHERD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.