MEDICARE: TIANA L SILVERS AGACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	0024181548	VA

General Provider Information

NPI Number	:	1033787049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA L SILVERS AGACNP-BC

Provider Business Mailing Address
First Line	:	14400 TOOLEY TER
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-6633
Country	:	US
Telephone Number	:	804-439-4886
Fax Number	:	804-768-6058

Provider Business Practice Location Address
First Line	:	14400 TOOLEY TER
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-6633
Country	:	US
Telephone Number	:	804-439-4886
Fax Number	:	804-768-6058

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

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	06/15/2021

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