| Tiffany E Polo, | |
|
1041 Sharon Rd, Suite 205, King William, VA 23086-3347 | |
| (804) 746-1677 | |
| (804) 769-3170 |
| Full Name | Tiffany E Polo |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 11 Years |
| Location | 1041 Sharon Rd, King William, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548640873 | NPI | - | NPPES |
| C05698 | Other | VA | GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 0024172717 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bon Secours Memorial Regional Medical Center | Mechanicsville, VA | Hospital |
| Bon Secours Richmond Community Hospital | Richmond, VA | Hospital |
| Bon Secours St Marys Hospital | Richmond, VA | Hospital |
| Henrico Doctors' Hospital | Richmond, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Richmond Heart And Vascular Associates | 4385039718 | 24 |
| Entity Name | Richmond Heart And Vascular Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508519745 PECOS PAC ID: 4385039718 Enrollment ID: O20220321002135 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany E Polo, 1041 Sharon Rd, Suite 205, King William, VA 23086-3347 Ph: (804) 746-1677 | Tiffany E Polo, 1041 Sharon Rd, Suite 205, King William, VA 23086-3347 Ph: (804) 746-1677 |
Jill S Storment, AGPCNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1041 Sharon Rd Ste 205, King William, VA 23086 Phone: 804-769-3096 Fax: 804-769-3170 |