| NPI | 1649711508 |
|---|---|
| Former Name | LAKESHA DESHUN TILLMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22412) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 903478) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2023-08-02 |