Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0024165265 | VA |
NPI | 1154439693 |
---|---|
Provider Name | Ms. Lori Ann Tilghman |
First Address | Midlothian, VA 23112-1656 |
Second Address | Richmond, VA 23235-4730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |