KELLY LYNN TILLMAN (NPI# 1467063073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467063073 |
| Entity Type | Individual |
| Full Name | KELLY LYNN TILLMAN |
| Practice Address |
1802 Cross Creek Rd Se Huntsville AL 35802-3970 |
| Practice Telephone | 2566034292 |
| Mailing Telephone | 2566034292 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518337278 | Kelly Tillman | Nurse Practitioner | 23702 Hwy 80 E, Statesboro, GA 30461-0845 | 2015-10-06 |
| Street Address |
1802 CROSS CREEK RD SE |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35802-3970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174187371 | Susan R. Bechert | Social Worker | Huntsville Psychotherapy and Counseling Services, 7540 S. Memorial Parkway, Suite W, Huntsville, AL 35802 | 2019-04-24 |
| 1932601416 | Crystal Gaskins | Nurse Practitioner | 700 Airport Road Suite D, Huntsville, AL 35802 | 2018-03-01 |
| 1073032736 | Emily Rachel Lapidus | Specialist/Technologist | 310 Devon Circle, Huntsville, AL 35802 | 2017-09-13 |
| 1467992727 | Thrive At Jones Farm | Assisted Living Facility | 2238 Cecil Ashburn Dr Se, Huntsville, AL 35802 | 2017-03-06 |
| 1922554641 | Acts Signature Community Services, Inc. | Internal Medicine | One Clubhouse Avenue, Huntsville, AL 35802 | 2016-09-01 |
| 1578018438 | Sarah Thompson | Marriage & Family Therapist | 116 Lily Flagg Rd Sw Ste D, Huntsville, AL 35802 | 2016-08-22 |
| 1124489166 | Nadine Wormsbacher | Massage Therapist | 919 Willowbrook Dr Suite D, Huntsville, AL 35802 | 2016-03-18 |
| 1962761486 | Alfred Lawrence Watson | Internal Medicine | 2112 Clubhouse Ave, Huntsville, AL 35802 | 2012-05-04 |
| 1992073449 | Susan Gosdin Weiler | Pharmacist | 2784 Carl T Jones Drive, Huntsville, AL 35802 | 2011-12-12 |
| 1518257823 | Bonnie Jo Ferguson | Pharmacist | 4096 Whitesburg Drive, Huntsville, AL 35802 | 2011-04-08 |
| Find all providers in zip 35802 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477166304 | Tia-ann Thompson | Student in an Organized Health Care Education/Training Program | 2435 Montgomery Rd Apt 214, Huntsville, TX 77340-6062 | 2020-08-29 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1528687167 | James Paul Molyneux | Student in an Organized Health Care Education/Training Program | 301 Governors Dr Sw Ste 389, Huntsville, AL 35801-5123 | 2020-04-14 |
| 1619507126 | Dwight Alexander Love | Student in an Organized Health Care Education/Training Program | 2531 Rita Ln Nw, Huntsville, AL 35810-3565 | 2020-01-23 |
| 1437789955 | Katherine Valentine | Student in an Organized Health Care Education/Training Program | 11300 Regency Way Sw, Huntsville, AL 35803-5014 | 2020-01-23 |
| 1649800152 | Olivia Hammond | Student in an Organized Health Care Education/Training Program | 55 Walnut Cove Blvd Sw, Huntsville, AL 35824-4046 | 2020-01-23 |
| 1619507118 | Caleb Aycock | Student in an Organized Health Care Education/Training Program | 138 Matt Phillips Rd Nw, Huntsville, AL 35806-2202 | 2020-01-23 |
| 1790245728 | Ashlyn Marie Alongi | Student in an Organized Health Care Education/Training Program | 1301 Deborah Dr Se, Huntsville, AL 35801-1491 | 2019-03-25 |
| 1700347655 | Eman Alshaikh | Student in an Organized Health Care Education/Training Program | 301 Governors Dr Sw Rm 240, Huntsville, AL 35801-5123 | 2019-03-25 |
| 1326512963 | Bethany Lynn Boyd | Student in an Organized Health Care Education/Training Program | 2821 Lake Rd Apt 10104, Huntsville, TX 77340-5990 | 2019-01-16 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35802 |
Please comment or provide details below to improve the information on KELLY LYNN TILLMAN.
| 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.