Provider Demographics
NPI:1275099186
Name:MCEWEN, TIFFANY YATES (MSN, AGNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:YATES
Last Name:MCEWEN
Suffix:
Gender:F
Credentials:MSN, AGNP
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:BROOKE
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN RD DUKE NORTH BOX # 3677
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-5910
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD DUKE NORTH BOX # 3677
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011476363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health