Most Relevant Information
Provider Data
| NPI Number: | 1003688979 |
| Provider Name: | CHEYENNE WILSON TILLEY PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 001013693 |
Most Important Dates
| Enumeration Date: | 10/24/2023 |
| Last Updated: | 06/14/2024 |
Provider Practice Location
723 S VAN BUREN RD STE B
EDEN
NC
272885418
Practice Location Phone/Fax
| Phone: | 3366235171 |
| Fax: |
Provider Mailing Location
723 S VAN BUREN RD STE B
EDEN
NC
272885418
Provider Mailing Phone/Fax
| Phone: | 3366131392 |
| Fax: |