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General NPI Number Information
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NPI Number | 1518319623
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Entity Type | Individual
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Provider Name | DEEANA LANE TILMAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 2831 TRICOM STREET SUTIE A
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-990-9244
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Fax | 843-806-2911
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Provider Business Mailing Address
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Address Line | 2831 TRICOM STREET SUTIE A
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-990-9244
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Fax | 843-806-2911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 20329
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 29172
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License Number State | TN
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