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Individual
SONJA FAYE TILLER
Active
Individual
SONJA FAYE TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP127124
TX
363LF0000X
Family Nurse Practitioner
Primary
AP127124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346907401
—
TX
01
—
752616977-18
TRICARE
TX
01
—
8708NN
BCBS
TX
01
—
P01464097
MEDICARE RAILROAD
TX
Enumeration date
02/10/2015
Last updated
12/20/2022
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