Healthcare Provider Details

I. General information

NPI: 1285558510
Provider Name (Legal Business Name): TIARA DUKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W JACKSON ST
RICH SQUARE NC
27869-9747
US

IV. Provider business mailing address

2323 KING MALCOLM LN
ZEBULON NC
27597-6736
US

V. Phone/Fax

Practice location:
  • Phone: 252-287-1660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27769
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: