Individual
LAURA TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Contact information
Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 578-5631
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R 190665-3
MN
Other
Enumeration date
03/25/2014
Last updated
10/16/2014
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