Individual
KATHERINE MARIE TILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4315 HIGHLAND PARK BLVD STE A, LAKELAND, FL 33813-1639
(863) 816-5884
(863) 940-4856
Mailing address
4315 HIGHLAND PARK BLVD STE A, LAKELAND, FL 33813-1639
(863) 816-5884
(863) 940-4856
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1102742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305087400
—
FL
Enumeration date
01/03/2007
Last updated
03/28/2017
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