Tillman, Crystal Lynne

Tillman, Crystal Lynne is an sole proprietor health care provider with primary practice located at 1055 Dresser Ct , Raleigh NC 27609-7323. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Tillman, Crystal Lynne can be contacted via phone (919) 876-3130.

Contact Information

Primary practice address
1055 Dresser Ct Raleigh NC 27609-7323
Phone: (919) 876-3130
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 300186 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 300186 North Carolina

Profile Details

NPI number 1609112333
LBN Legal business name Tillman, Crystal Lynne
Credentials DNP, CPNP, PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2012
Last updated Oct 28th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609112333 NPPES
North Carolina Other 300186 NURSING AND MEDICAL BOARD PRESCRIBING NUMBER

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