Provider Demographics
NPI:1669234282
Name:TILGHMAN, CONSTANCE (LPN)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:TILGHMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 STRATHPINE DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-8050
Mailing Address - Country:US
Mailing Address - Phone:854-213-7776
Mailing Address - Fax:
Practice Address - Street 1:47 FISHERMAN LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5013
Practice Address - Country:US
Practice Address - Phone:855-390-6568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse