Individual
LAURA LEE TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
18948 US HIGHWAY 58, CASTLEWOOD, VA 24224-6032
(276) 762-2172
(276) 762-5039
Mailing address
2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
(423) 434-6677
(423) 461-0000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024180161
VA
363LF0000X
Family Nurse Practitioner
Primary
0024180161
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639755234
—
VA
Enumeration date
03/23/2021
Last updated
04/22/2026
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