Provider Demographics
NPI:1801031109
Name:COUNCILL, TIFFANY WATSON (ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:WATSON
Last Name:COUNCILL
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 DOCTORS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-4501
Mailing Address - Country:US
Mailing Address - Phone:828-586-3976
Mailing Address - Fax:
Practice Address - Street 1:98 DOCTORS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4501
Practice Address - Country:US
Practice Address - Phone:828-586-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004439363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care