Individual
KATY TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 HIGHWAY 411, VONORE, TN 37885-2455
(423) 884-7271
(423) 884-3277
Mailing address
PO BOX 278, MADISONVILLE, TN 37354-0278
(423) 442-2622
(423) 442-5760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20895
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20895
STATE LICENSE
TN
Enumeration date
03/17/2016
Last updated
03/17/2016
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