Laura Tillman, C.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R 190665-3 Issued in MN

Practice address

200 University Ave E
Saint Paul, MN 55101-2507

Phone

(651) 578-5631

NPI assigned

Mar 25, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • St. Paul, MN
  • NPI 1225119175
  Medicare reassignment NPD
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1982090528
  NPD
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1427475706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-578-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "LAURA",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R 190665-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L Thul, MD
• Heather Thurmes, MA,LADC
• Abigail House Tierney, PA
• Susan Jeanne Tietjen, LMT
• Rute Tilahun
• Nicole Emma Tilzer
• Hannah Tima
• Christy L Timm-Hughes, NP
• Liudmila Petrovna Timm, LPCC
• Michael R Timm, PAC

• Pediatric Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.