Individual
MRS. LYNETTE COLLIER TILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2626 VAUGHAN RD, BULLOCK, NC 27507-9441
(919) 690-1134
Mailing address
2626 VAUGHAN RD, BULLOCK, NC 27507-9441
(919) 690-1134
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190165
NC
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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