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NPI Profile for VICKIE B TILLEY in LOGAN, UT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X |
| NPI # | 1851613566 |
|
| Status | Active | |
| Credentials | RN, CDE | |
| Entity | Individual | |
| Enumeration date | 02/22/2010 | |
| Last updated | 02/22/2010 - About 16 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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VICKIE B TILLEY
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VICKIE B TILLEY, RN, CDE