Doctor Name: | PATRICIA MARIE TILLEMAN |
NPI Number: | 1720258908 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 12815 |
Business Practice Address: | Rr 1 Box 664 Box Elder, MT - 595219797 |
Business Phone Number: | 4063954486 |
Business Fax Number: | 4063955850 |
Mailing Address: | Rr 1 Box 664, BOX ELDER |
State: | MT |
Postal Code: | 595219797 |
Phone Number: | 4063954486 |
Fax Number: | 4063955850 |
NPI Enumeration Date: | 03/04/2008 |
NPI Last Update Date: | 03/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP2201X |
License Number: | 12815 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Ambulatory Care |
Taxonomy Definition: |