Individual
JOHNITA TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 CHESTNUT HILL PLZ STE C, NEWARK, DE 19713-2761
(302) 455-2730
(302) 455-2731
Mailing address
1 CHESTNUT HILL PLZ STE C, NEWARK, DE 19713-2761
(302) 455-2730
(302) 455-2731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
AC006538
MD
163W00000X
Registered Nurse
L1-0035771
DE
363L00000X
Nurse Practitioner
LG-0001146
DE
363LF0000X
Family Nurse Practitioner
AC006538
MD
363LF0000X
Family Nurse Practitioner
Primary
LG-0001146
DE
Other
Enumeration date
07/23/2018
Last updated
08/23/2024
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