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Organization
KIMBERLY L TILLMAN
Active
Organization
KIMBERLY L TILLMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY L TILLMAN (PN.M-IV)
(216) 246-8014
Entity
Organization
Contact information
Practice address
11410 ASHBURY AVE, CLEVELAND, OH 44106-1310
(216) 246-8014
Mailing address
11410 ASHBURY AVE, CLEVELAND, OH 44106-1310
(216) 246-8014
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.143666M-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PN.143666-M-IV
—
OH
Enumeration date
07/03/2014
Last updated
07/03/2014
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