Individual
MARY MARIE TILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
4850 UNION AVE, SAN JOSE, CA 95124-5156
(800) 913-2615
Mailing address
2542 S BASCOM AVE STE 110, CAMPBELL, CA 95008-5541
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95030847
CA
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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