| NPI | 1528509825 |
|---|---|
| Former Name | LANA BETH TILLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 22356) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 22356) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22356) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-11-27 |