Healthcare Provider Details

I. General information

NPI: 1437104759
Provider Name (Legal Business Name): ALL WOMAN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 DIXIE HWY STE C
FT WRIGHT KY
41011-2792
US

IV. Provider business mailing address

PO BOX 17510
COVINGTON KY
41017-0510
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-5550
  • Fax: 859-344-3782
Mailing address:
  • Phone: 859-341-5550
  • Fax: 859-344-3782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. APRIL M TILLERY
Title or Position: OWNER
Credential: MD
Phone: 859-341-5550