Individual
TRACI M. TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-5000
(706) 509-4608
Mailing address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3224
(706) 509-3278
(706) 509-4608
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
106991
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
GA
Enumeration date
08/30/2006
Last updated
10/28/2025
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