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NPI Profile for LEESA K TILOTTA in POPLAR BLUFF, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner |
| NPI Number | 1093823767 |
|
| Status | Active | |
| Credentials | NP (Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 08/25/2006 | |
| Last updated | 07/09/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LEESA K TILOTTA
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LEESA K TILOTTA, NP