Tillman, Patrice Vivien
Tillman, Patrice Vivien is an sole proprietor health care provider with primary practice located at 175 Gwinnett Dr , Lawrenceville GA 30045-8444. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Tillman, Patrice Vivien can be contacted via phone (770) 339-5000.Contact Information
Primary practice address
175 Gwinnett Dr
Lawrenceville GA 30045-8444
Phone: (770) 339-5000
Fax: (770) 822-1698
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Psychiatric/Mental Health, Adult | 163WP0809X | RN058224 | Georgia |
Profile Details
| NPI number | 1992852123 |
|---|---|
| LBN Legal business name | Tillman, Patrice Vivien |
| Credentials | RN,MSN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992852123 | NPPES |
| Georgia | Other | RN058224 | RN LIC. |
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