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General NPI Number Information
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NPI Number | 1356495725
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Entity Type | Individual
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Provider Name | KIMBERLY JANE ROSS-TILLEY MSN, RN, NCC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 805 RIVER RD
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City | DOVER
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State | DE
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Zip | 19901-3753
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Country | US
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Telephone | 302-739-4728
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 IRISH HILL RD
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City | FELTON
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State | DE
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Zip | 19943-5449
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Country | US
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Telephone | 302-284-8636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | L1-0016309
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License Number State | DE
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