KELLY TILLMAN (NPI# 1518337278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518337278 |
| Entity Type | Individual |
| Full Name | KELLY TILLMAN |
| Practice Address |
23702 Hwy 80 E Statesboro GA 30461-0845 |
| Mailing Address |
4700 Waters Ave Savannah GA 31404-6220 |
| Practice Telephone | 9124894090 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN161574 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467063073 | Kelly Lynn Tillman | Student in an Organized Health Care Education/Training Program | 1802 Cross Creek Rd Se, Huntsville, AL 35802-3970 | 2020-08-17 |
| Street Address |
23702 HWY 80 E |
| City | STATESBORO |
| State | GA |
| Zip Code | 30461-0845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104874031 | Thaddeus H Riley | Family Medicine | 23702 Hwy 80 E, Statesboro, GA 30458 | 2006-05-04 |
| 1710452677 | Malini Stewart | Dietitian, Registered | 23702 Hwy 80 E, Statesboro, GA 30461-0845 | 2018-10-08 |
| 1912259797 | Amy Jo Riggs | Dietitian, Registered | 23702 Hwy 80 E, Statesboro, GA 30461-0845 | 2012-10-04 |
| 1760689319 | Angela Marie Davis | Family Medicine | 23702 Hwy 80 E, Statesboro, GA 30461-0845 | 2007-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427592765 | Scarlet Gabrielle Shumate | Student in an Organized Health Care Education/Training Program | 1332 Southern Dr., Statesboro, GA 30461 | 2016-12-06 |
| 1164972642 | Olivia Anne Chester | Occupational Therapist | 5968 Lakeview Road, Statesboro, GA 30461 | 2016-10-10 |
| 1760672653 | Dawn Miller | Social Worker | 9017 Oakfield Drive, Statesboro, GA 30461 | 2007-07-27 |
| 1619167608 | Timothy Rollins Ussery | Specialist/Technologist | 16741 Hwy 67 South, Suite 1-a, Statesboro, GA 30461 | 2007-07-26 |
| 1245444579 | Chen-wen Shih | Obstetrics & Gynecology | 4002 Denton Loop, Statesboro, GA 30461 | 2007-05-09 |
| 1215149497 | A. Deo Klein, M.d., P.C. | Specialist | 1161 Sarahlyn Lane, Ste. A, Statesboro, GA 30461 | 2007-05-03 |
| 1568480051 | Robert William Cushner | Podiatrist | 95 Bel Air Drive, Statesboro, GA 30461 | 2006-07-17 |
| 1356619613 | Statesboro Ambulatory Surgery Center, Inc | Clinic/Center | 95 Bel Air Drive, Statesboro, GA 30461 | 2011-12-01 |
| 1497883243 | Jennifer Lea Williamson | Physician Assistant | 1012 Bermuda Run, Statesboro, GA 30461 | 2007-03-02 |
| 1467569376 | Statesboro Ambul Surg Ctr Inc | Clinic/Center | 95 Bel Air Drive, Statesboro, GA 30461 | 2006-08-24 |
| Find all providers in zip 30461 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014425 | Heather Sumner Herrin | Nurse Practitioner | 3024 Mccall Blvd, Statesboro, GA 30461-4919 | 2020-05-17 |
| 1235759895 | Health and Wellness PC | Nurse Practitioner | 1303 Sunset Cir, Statesboro, GA 30458-1575 | 2020-04-23 |
| 1619434917 | Kathryn Lynn Bowen-williams | Nurse Practitioner | 1800 Js Nesmith Rd, Statesboro, GA 30458-3613 | 2019-02-23 |
| 1306337332 | Phyllis Evon Solomon | Nurse Practitioner | 930 Teepee Way, Statesboro, GA 30461-6786 | 2018-05-25 |
| 1588185904 | Erica B Lanier | Nurse Practitioner | 5219 Williams Rd, Statesboro, GA 30458-0122 | 2017-07-06 |
| 1053849174 | Julie Laing Giardina | Nurse Practitioner | 7251 Zell Miller Pkwy, Statesboro, GA 30458-3487 | 2017-06-02 |
| 1700259108 | Melissa Beasley | Nurse Practitioner | 450 Georgia Ave Ste B, Statesboro, GA 30458-5590 | 2015-11-06 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1720428055 | Beverly B. Smith | Nurse Practitioner | 2331 Franklin Rd, Statesboro, GA 30461-7584 | 2013-07-01 |
| 1295081685 | Alan W Skipper | Nurse Practitioner | 127 N College St, Statesboro, GA 30458-5387 | 2012-08-03 |
| Find all providers in STATESBORO | ||||
| City | STATESBORO |
| Zip Code | 30461 |
Please comment or provide details below to improve the information on KELLY 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.