Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tiffany Wallace, DNP

Individual provider Nurse Practitioner · NPI 1942804612

Mrs. Tiffany Wallace, DNP is a Nurse Practitioner in Greensboro, North Carolina. Qualified in 2020, 6 years ago. Practices with Moses Cone Affiliated Physicians, Inc, a 79-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2020
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

719 Green Valley Rd
Greensboro, NC 27408-7014
Phone: (336) 275-5391
Fax: (336) 275-4702
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5013821 (NC)

Record details

NPI number1942804612
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP
Sole proprietorNo
NPI enumeratedNovember 24, 2020
Last updated in NPPESAugust 19, 2021
Certification dateAugust 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Moses Cone Affiliated Physicians, Inc. — 79 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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