| Doctor Name: | PATRICIA L TILLER |
| NPI Number: | 1205983095 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CARE PROVIDER |
| License Number: | FCL-092-042 |
| Business Practice Address: | 312 E. Earp St Holly Springs, NC - 275400582 |
| Business Phone Number: | 9195524849 |
| Business Fax Number: | 9195577391 |
| Mailing Address: | Po Box 582, 312 E. Earp St. HOLLY SPRINGS |
| State: | NC |
| Postal Code: | 275400582 |
| Phone Number: | 9195524849 |
| Fax Number: | 9195577391 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 177F00000X |
| License Number: | FCL-092-042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Lodging |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |