Individual
MS. SHARON TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3368 E 66TH ST, CLEVELAND, OH 44127-1905
(216) 341-0208
Mailing address
3368 E 66TH ST, CLEVELAND, OH 44127-1905
(216) 341-0208
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN.084599-MEDS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125671
—
OH
Enumeration date
08/28/2014
Last updated
08/28/2014
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