HEATHER MICHELLE TILLERY (NPI# 1043631096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043631096 |
| Entity Type | Individual |
| Full Name | HEATHER MICHELLE TILLERY |
| Other Name | HEATHER TILLERY |
| Credential | FNP |
| Practice Address |
200 S Enota Dr Ne Ste 100 Gainesville GA 30501-3466 |
| Mailing Address |
Po Box 742616 Atlanta GA 30374-2616 |
| Practice Telephone | 7705342020 |
| Practice Fax Number | 7705348025 |
| Mailing Telephone | 7702198420 |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN206952 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 S ENOTA DR NE STE 100 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679572069 | Sudhakara Babu Chennareddy | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2005-07-18 |
| 1740739853 | Christopher Blake Ennis | Nurse Practitioner | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2016-09-30 |
| 1437530326 | Shelley A. Robertson | Nurse Practitioner | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2015-06-16 |
| 1801288337 | Rachel E Lebolo | Nurse Practitioner | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2015-02-20 |
| 1851721161 | Elizabeth Illing | Nurse Practitioner | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501 | 2013-11-22 |
| 1558687384 | Ugochukwu Onyibo Egolum | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2010-04-19 |
| 1386872729 | Vedang J Bhavsar | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2009-06-24 |
| 1740431295 | Santhi Adigopula | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2008-10-02 |
| 1578727038 | Ioannis Parastatidis | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2008-07-14 |
| 1013197995 | Nitya Sthalekar | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2007-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908446 | Jade Asante-selby | Nurse Practitioner | 3030 Mcever Rd Ste 130, Gainesville, GA 30504-5538 | 2020-09-28 |
| 1295349405 | Mildred K Myrtil | Nurse Practitioner | 3754 Nw 54th Ln, Gainesville, FL 32653-0859 | 2020-09-04 |
| 1821608712 | Talia Rose Maschino | Nurse Practitioner | 1430 Se 51st St, Gainesville, FL 32641-1962 | 2020-08-05 |
| 1760006282 | Chariza Parsons Lopez | Nurse Practitioner | 8340 Nw 51st St, Gainesville, FL 32653-6182 | 2020-06-01 |
| 1255961017 | Whitney Necole Mcneely | Nurse Practitioner | 3009 Sw Williston Rd, Gainesville, FL 32608-3928 | 2020-01-21 |
| 1255961249 | Jared David Mincey | Nurse Practitioner | 10405 Sw 122nd St, Gainesville, FL 32608-5843 | 2020-01-19 |
| 1346870565 | Emily Grace Holbrook | Nurse Practitioner | 650 Crestview Ter, Gainesville, GA 30501-3110 | 2020-01-16 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1124676218 | Fasika T Enyew | Nurse Practitioner | 1870 Atlanta Hwy, Gainesville, GA 30504-5948 | 2019-08-31 |
| 1821641416 | Julie Tiegs | Nurse Practitioner | 5431 Little River Cir, Gainesville, GA 30506-3191 | 2019-07-22 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on HEATHER MICHELLE TILLERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.