# ANTOINETTE MICHELE TILLMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1043986490
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | R080373 | MD | Yes |
| 363LF0000X | Family Nurse Practitioner | R080373 | MD | — |

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 03/12/2025