Individual
MCKAY TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1212 E SUNSET DR, MONROE, NC 28112-4318
(704) 283-8548
Mailing address
PO BOX 210, PEACHLAND, NC 28133-0210
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5016462
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825286393
—
NC
Enumeration date
07/04/2022
Last updated
07/04/2022
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