Katherine Kelle Tillman, APRN ACNS-BC

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

AP129952 Issued in TX

Practice address

1919 8TH Ave
Fort Worth, TX 76110-1358

Phone

(817) 332-7722

Fax

(817) 582-4977

NPI assigned

Jun 18, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelle.tillman.1@16243.direct.athenahealth.com

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.

• Health Education Learning Project

  • Clinic/Center
  • Fort Worth, TX
  • NPI 1679228126
  NPD Authorized official

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1720648140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101358",
            "telephone_number": "817-332-7722",
            "fax_number": "817-582-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101358",
            "telephone_number": "817-332-7722",
            "fax_number": "817-582-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "KATHERINE",
        "middle_name": "KELLE",
        "credential": "APRN ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "AP129952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marva J Tilleman
• Celya N Tilley, FNP-BC
• Jo Ann Tilley, CPNP
• Julia Tillie, L.C.S.W.
• Gregg Harrison Tillman, DDS
• Michael David Tillman, DDS
• Tricia Tillman
• Cally Lynn Tilly, LPC
• Tim P Kret OD, PA
• Timber Creek Dental & Orthodontics

• Administrator Registered Nurse in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Administrator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.