Individual
JERELYN H TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2800 ALLISON BONNETT MEMORIAL DR, HUEYTOWN, AL 35023-1845
(205) 744-4410
(205) 744-6150
Mailing address
1130 22ND ST S, RIDGE PARK PLACE, SUITE 1000, BIRMINGHAM, AL 35205-2870
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1139395
AL
363LW0102X
Women's Health Nurse Practitioner
1139395
AL
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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