Individual
MS. SHONA MONIC TILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(579) 751-5711
Mailing address
1718 W SUDAN CIR, GREENVILLE, MS 38701-7548
(662) 822-2169
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
226060
AR
363LA2100X
Acute Care Nurse Practitioner
905185
MS
Other
Enumeration date
04/28/2022
Last updated
02/14/2025
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