Provider Demographics
NPI:1518319623
Name:TILMAN, DEEANA LANE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:DEEANA
Middle Name:LANE
Last Name:TILMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DEEANA
Other - Middle Name:LANE
Other - Last Name:BURR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2831 TRICOM STREET
Mailing Address - Street 2:SUTIE A
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-990-9244
Mailing Address - Fax:843-806-2911
Practice Address - Street 1:2831 TRICOM STREET
Practice Address - Street 2:SUTIE A
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-990-9244
Practice Address - Fax:843-806-2911
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20329363LF0000X
TN29172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily