Individual
KENHDRA TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1029 PRIGGE RD, SAINT LOUIS, MO 63138-3553
(314) 406-4315
Mailing address
10617 DUNKELD CIR, SAINT LOUIS, MO 63137-3855
(314) 406-4315
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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