MS. PATRICIA SUE TILLACK (NPI# 1861459042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861459042 |
| Entity Type | Individual |
| Full Name | MS. PATRICIA SUE TILLACK |
| Other Name | MRS. PATRICIA SUE ORMSBY |
| Credential | ANP |
| Practice Address |
9224 N 28th St Phoenix AZ 85028-4705 |
| Practice Telephone | 6025106977 |
| Practice Fax Number | 6027951442 |
| Mailing Telephone | 6025106977 |
| Mailing Fax Number | 6027951442 |
| Enumeration Date | 2006-04-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
186 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9224 N 28TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85028-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235626565 | Celice Korsten | Psychologist | 11020 N. Tatum Blvd., Ste. 100, Phoenix, AZ 85028 | 2018-04-23 |
| 1720591605 | Michele Kaplan | Counselor | 11640 N Tatum Blvd #3096, Phoenix, AZ 85028 | 2017-11-14 |
| 1154840304 | Faustino M. Gonzalez, Md PC | Anesthesiology | 11811 N. Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2017-09-19 |
| 1679092514 | Savior Palliative Care LLC | Family Medicine | 4530 E Shea Blvd Ste 175, Phoenix, AZ 85028 | 2017-09-12 |
| 1437688892 | Harmony Behavioral Health | Behavioral Analyst | 3008 E Sierra St, Phoenix, AZ 85028 | 2017-06-08 |
| 1275949224 | Alexander D Garza | Podiatrist | 3101 E Shea Blvd Ste 220, Phoenix, AZ 85028 | 2014-07-09 |
| 1720418379 | Alyssa Hale | Occupational Therapy Assistant | 4600 East Shea Boulevard, Suite 101, Phoenix, AZ 85028 | 2013-11-19 |
| 1932534476 | Stephen Howard Garber | Otolaryngology | 9607 N. 43rd Way, Phoenix, AZ 85028 | 2013-09-03 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1285930925 | Cathy Ann Payne | Nurse Practitioner | 11209 N Tatum Blvd Ste 260, Phoenix, AZ 85028 | 2011-01-27 |
| Find all providers in zip 85028 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819230 | Care On Pllc | Nurse Practitioner | 7171 S 51 Ave, Phoenix, AZ 85339-2923 | 2020-07-23 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1710522024 | Kelsey Conrad | Nurse Practitioner | 1 E Lexington Ave Unit 1602, Phoenix, AZ 85012-4203 | 2019-11-11 |
| 1124662408 | Rayiom Health and Wellness, Inc | Nurse Practitioner | 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 | 2019-10-30 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1598135741 | Sandra Shearer | Nurse Practitioner | 513 W Lavitt Ln, Phoenix, AZ 85086-6346 | 2015-09-30 |
| 1023499860 | Kelly Lynn Schultz | Nurse Practitioner | 3944 E Hillery Dr, Phoenix, AZ 85032-5245 | 2015-06-17 |
| 1609298900 | Lorna Ann Hill | Nurse Practitioner | 13224 N 31st Pl, Phoenix, AZ 85032-6041 | 2014-01-06 |
| 1801217765 | Trifit Pain Management LLC | Nurse Practitioner | 505 E Camelback Rd, Phoenix, AZ 85012-1615 | 2013-12-19 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.