Tifane S Chambers
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Carthage, NC
NPI 1154042604 · NPPES record last updated Dec 3, 2023
Key facts
- NPI
- 1154042604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 5017530 (NC)
- Practice address
- 516 Union Church Rd
Carthage, NC 28327-7648 - Phone
- (910) 391-6509
- NPI assigned
- Sep 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5017530 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
| CHAM-MR350 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fresh Start Family Behavioral Wellness, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | CHAM-MR350 | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CHAM-MR350 | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5017530 | NC | Yes |
Addresses
Primary practice location
516 Union Church Rd
Carthage, NC 28327-7648
Mailing address
516 Union Church Rd
Carthage, NC 28327-7648
Phone (910) 391-6509
Other practice location 1
200 Gilchrist Rd
Cameron, NC 28326-9453
Phone (910) 391-6509
Other providers in Carthage, NC
- Bradley Langley DDS PLLC
- David Brill
- Roberta Kathleen Britt
- Carthage Family Care PA
- Carthage Healthcare Inc.
- Charles M. Guizzotti, D.D.S., P.a.
- Katie Irene Chisolm
- County of Moore
- County of Moore
- Kimberly Sue-Hicks Donze
All providers in Carthage, NC · Psychiatric/Mental Health Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.