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NPI Code Detail

MEDICARE: MS. DEEANA LANE TILMAN FNP-BC

MEDICARE:  MS. DEEANA LANE TILMAN  FNP-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
1363LF0000XFamily Nurse Practitioner20329SC
2363LF0000XFamily Nurse Practitioner29172TN

General Provider Information

NPI Number : 1518319623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEEANA LANE TILMAN FNP-BC
Provider Business Mailing Address
First Line : 2831 TRICOM STREET
Second Line : SUTIE A
City : NORTH CHARLESTON
State : SC
Zip : 29406
Country : US
Telephone Number : 843-990-9244
Fax Number : 843-806-2911
Provider Business Practice Location Address
First Line : 2831 TRICOM STREET
Second Line : SUTIE A
City : NORTH CHARLESTON
State : SC
Zip : 29406
Country : US
Telephone Number : 843-990-9244
Fax Number : 843-806-2911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2016
Last Update Date : 08/26/2025

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Directions to “ MS. DEEANA LANE TILMAN FNP-BC” Practice Location

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