Individual provider · Type 1 NPI
Chanel T. Tillery, DNP, APRN, FNP-C
Family Nurse Practitioner · Newark, NJ
NPI number
1083463657
Active
Practice location
150 Bergen St
Newark, NJ 07103-2496
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 26NR20372200 (NJ) |
| Family Nurse Practitioner Primary | 363LF0000X | 26NJ15148700 (NJ) |
Family Nurse Practitioner: Definition to come...
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About NPI 1083463657
Chanel T. Tillery, DNP, APRN, FNP-C's National Provider Identifier is 1083463657, issued on May 16, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Newark, NJ. The record was last updated on Sep 19, 2024.